Analysis of the IgG subclass distribution and inflammatory infiltrates in patients with anti-Hu-associated paraneoplastic encephalomyelitis Journal Article
| Authors: | Jean, W. C.; Dalmau, J.; Ho, A.; Posner, J. B. |
| Article Title: | Analysis of the IgG subclass distribution and inflammatory infiltrates in patients with anti-Hu-associated paraneoplastic encephalomyelitis |
| Abstract: | Using immunohistochemistry, we studied the IgG subclass distribution of the anti-Hu antibody in serum, nervous system, and tumor of patients with anti-Hu-associated paraneoplastic encephalomyelitis/sensory neuronopathy (PEM/PSN). The nervous system was also examined for deposits of complement and the distribution and type of inflammatory cells. IgG1 and IgG3 were the predominant isotypes of the anti-Hu IgG in serum, nervous system, and tumor. A few patients also had anti-Hu IgG2, but this isotype was not consistently present in all the regions of the nervous system studied. There was no correlation between neurologic symptoms and specific anti-Hu isotype, nor was there evidence that different anti-Hu isotypes recognized specific brain regions. Although IgG1 and IgG3 can activate complement, only weak complement reactivity was found, and that only in a few areas of the nervous system. This finding, in addition to the absence of natural killer (NK) cells, suggested that complement-mediated toxicity and antibody-dependent cell cytotoxicity mediated by NK cells are not pathogenic in PEM/PSN. Inflammatory infiltrates included CD19+ (B cells) and CD4+ (helper/inducer) cells in the perivascular spaces, and lymphocytes bearing CD8+CDllb- markers (cytotoxic T cells) in the interstitial spaces. Infiltrates of EBM11+ (monocyte/macrophage) cells were identified in the perivascular spaces (macrophage phenotype) and in those interstitial regions (microglial pheno-type) with severe pathologic changes. The ability of the IgG1 and IgG3 isotypes to bind Fc receptors may have played a role in the recruitment of these monocyte/macrophage cells. We conclude that anti-Hu-associated PEM/PSN is a complex immune disorder in which both cell-mediated and humoral (probably non-CMT and non-ADCC) cytotoxic mechanisms appear to be involved in its pathogenesis. © 1994 American Academy of Neurology. |
| Keywords: | immunohistochemistry; clinical article; controlled study; human tissue; dna-binding proteins; sensory neuropathy; rna binding protein; blood; bacterial proteins; immunoglobulin g; tissue distribution; antibodies; immunoglobulin g1; immunoglobulin g3; inflammatory infiltrate; tumor; paraneoplastic syndrome; immunopathology; complement; nervous system; encephalomyelitis; paraneoplastic syndromes; human; priority journal; article; immunoglobulin g2 |
| Journal Title: | Neurology |
| Volume: | 44 |
| Issue: | 1 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1994-01-01 |
| Start Page: | 140 |
| End Page: | 147 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 8290049 |
| DOI: | 10.1212/wnl.44.1.140 |
| DOI/URL: | |
| Notes: | Export Date: 14 January 2019 -- Article -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work