Encephalitis with Autoantibodies against the Glutamate Kainate Receptors GluK2

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Joana Da Cruz Guimarães Ferreira De Almeida

    Autor

Participantes de fora da FMUP

  • Landa, J
  • Guasp, M
  • Míguez-Cabello, F
  • Mishima, T
  • Oda, F
  • Zipp, F
  • Krajinovic, V
  • Fuhr, P
  • Honnorat, J
  • Titulaer, M
  • Simabukuro, M
  • Planagumà, J
  • Martínez-Hernández, E
  • Armangué, T
  • Saiz, A
  • Gasull, X
  • Soto, D
  • Graus, F
  • Sabater, L
  • Dalmau, J
  • Gluk2 Encephalitis Study Grp

Unidades de investigação

Abstract

Objective The objective of this study was to report the identification of antibodies against the glutamate kainate receptor subunit 2 (GluK2-abs) in patients with autoimmune encephalitis, and describe the clinical-immunological features and antibody effects. Methods Two sera from 8 patients with similar rat brain immunostaining were used to precipitate the antigen from neuronal cultures. A cell-based assay (CBA) with GluK2-expressing HEK293 cells was used to assess 596 patients with different neurological disorders, and 23 healthy controls. GluK2-ab effects were determined by confocal microscopy in cultured neurons and electrophysiology in GluK2-expressing HEK293 cells. Results Patients' antibodies precipitated GluK2. GluK2 antibody-specificity was confirmed by CBA, immunoprecipitation, GluK2-immunoabsorption, and GluK2 knockout brain immunohistochemistry. In 2 of 8 samples, antibodies reacted with additional GluK2 epitopes present in GluK1 or GluK3; in both, the reactivity was abrogated after GluK2 immuno-absorption. Six of 8 patients developed acute encephalitis and clinical or magnetic resonance imaging (MRI) features of predominant cerebellar involvement (4 presenting as cerebellitis, which in 2 patients caused obstructive hydrocephalus), and 2 patients had other syndromes (1 with cerebellar symptoms). One of the samples showed mild reactivity with non-kainate receptors (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors [AMPAR] and N-methyl-D-aspartate receptors [NMDAR]) leading to identify 6 additional cases with GluK2-abs among patients with anti-AMPAR (5/71) or anti-NMDAR encephalitis (1/73). GluK2-abs internalized GluK2 in HEK293 cells and neurons; these antibody-effects were reversible in neurons. A significant reduction of GluK2-mediated currents was observed in cells treated with patients' GluK2 serum following the time frame of antibody-mediated GluK2 internalization. Interpretation GluK2-abs associate with an encephalitis with prominent clinicoradiological cerebellar involvement. The antibody effects are predominantly mediated by internalization of GluK2. ANN NEUROL 2021

Dados da publicação

ISSN/ISSNe:
1531-8249, 0364-5134

Annals of Neurology  John Wiley & Sons Inc.

Tipo:
Article
Páginas:
101-117

Citações Recebidas na Web of Science: 12

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Keywords

  • OPSOCLONUS-MYOCLONUS SYNDROME; CASE SERIES; ACUTE CEREBELLITIS; ANTIBODIES; NMDA; AMPA; TERM; MECHANISMS; PLASTICITY; ANTIGEN

Financiamento

Proyectos asociados

Optical Coherence Tomography in Multiple Sclerosis patients regarding history of Optic Neuritis: a Portuguese hospital-based study

Investigador Principal: Joana da Cruz Guimarães Ferreira de Almeida

Estudo Clínico Académico (Multiple Sclerosis) . 2020

Optic Neuropathy: a 15-year retrospective observational study

Investigador Principal: Joana da Cruz Guimarães Ferreira de Almeida

Estudo Clínico Académico (Optic) . 2020

NMO Vs. Multiple Sclerosis: Are the associated autoimmune diseases the same?"

Investigador Principal: Joana da Cruz Guimarães Ferreira de Almeida

Estudo Clínico Académico (NMO) . 2020

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