Journal Article DZNE-2024-01140

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Human cerebrospinal fluid monoclonal CASPR2 autoantibodies induce changes in electrophysiology, functional MRI, and behavior in rodent models.

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2024
Academic Press Orlando, Fla.

Brain, behavior and immunity 122, 266 - 278 () [10.1016/j.bbi.2024.08.027]

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Abstract: Anti-contactin associated protein receptor 2 (CASPR2) encephalitis is a severe autoimmune encephalitis with a variable clinical phenotype including behavioral abnormalities, cognitive decline, epileptic seizures, peripheral nerve hyperexcitability and neuropathic pain. The detailed mechanisms of how CASPR2 autoantibodies lead to synaptic dysfunction and clinical symptoms are largely unknown. Aiming for analyses from the molecular to the clinical level, we isolated antibody-secreting cells from the cerebrospinal fluid of two patients with CASPR2 encephalitis. From these we cloned four anti-CASPR2 human monoclonal autoantibodies (mAbs) with strong binding to brain and peripheral nerves. All were highly hypermutated and mainly of the IgG4 subclass. Mutagenesis studies determined selective binding to the discoidin domain of CASPR2. Surface plasmon resonance revealed affinities with dissociation constants KD in the pico- to nanomolar range. CASPR2 mAbs interrupted the interaction of CASPR2 with its binding partner contactin 2 in vitro and were internalized after binding to CASPR2-expressing cells. Electrophysiological recordings of rat hippocampal slices after stereotactic injection of CASPR2 mAbs showed characteristic afterpotentials following electrical stimulation. In vivo experiments with intracerebroventricular administration of human CASPR2 mAbs into mice and rats showed EEG-recorded brain hyperexcitability but no spontaneous recurrent seizures. Behavioral assessment of infused mice showed a subtle clinical phenotype, mainly affecting sociability. Mouse brain MRI exhibited markedly reduced resting-state functional connectivity without short-term structural changes. Together, the experimental data support the direct pathogenicity of CASPR2 autoantibodies. The minimally invasive EEG and MRI techniques applied here may serve as novel objective, quantifiable tools for improved animal models, in particular for subtle neuropsychiatric phenotypes or repeated measurements.

Keyword(s): Animals (MeSH) ; Autoantibodies: immunology (MeSH) ; Autoantibodies: metabolism (MeSH) ; Rats (MeSH) ; Humans (MeSH) ; Mice (MeSH) ; Magnetic Resonance Imaging: methods (MeSH) ; Nerve Tissue Proteins: immunology (MeSH) ; Nerve Tissue Proteins: metabolism (MeSH) ; Antibodies, Monoclonal (MeSH) ; Male (MeSH) ; Encephalitis: immunology (MeSH) ; Encephalitis: metabolism (MeSH) ; Membrane Proteins: metabolism (MeSH) ; Membrane Proteins: immunology (MeSH) ; Disease Models, Animal (MeSH) ; Female (MeSH) ; Brain: metabolism (MeSH) ; Hippocampus: metabolism (MeSH) ; Behavior, Animal: physiology (MeSH) ; Autoantibodies ; Autoimmune encephalitis ; CASPR2 ; Human monoclonal antibody ; Mouse MRI ; Autoantibodies ; CNTNAP2 protein, human ; Nerve Tissue Proteins ; Antibodies, Monoclonal ; Membrane Proteins

Classification:

Contributing Institute(s):
  1. Autoimmune Encephalopathies (AG Prüß)
Research Program(s):
  1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2024
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Medline ; Creative Commons Attribution CC BY 4.0 ; OpenAccess ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 15 ; JCR ; NationallizenzNationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2024-09-17, last modified 2026-03-10