DOI: 10.1097/01.NT.0000455665.51754.52
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Issn Print: 1533-7006
Publication Date: 2014/10/02
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Excerpt
Researchers in Germany have found in a systematic screen that autoantibodies known to be directed at brain antigens had the same prevalence in the serum of healthy people as they did in those with neuropsychiatric illnesses. The findings, they said, offer reason to reassess the role of these autoantibodies in the detection and treatment of these conditions.
The serum of 1,700 healthy individuals and 2,500 diseased individuals were tested for 25 autoantibodies, and the seroprevalence of all of the autoantibodies was comparable in both groups, said the research team, led by Hannelore Ehrenreich, MD, DVM, a professor of clinical neuroscience at the Max Planck Institute of Experimental Medicine in Gottingen, Germany. The findings were published in the July 23 online edition of Annals of Neurology.
The study is the first systematic screening of serum samples from a large number of subjects, both those with disease and healthy controls.
Dr. Ehrenreich said the findings should give physicians pause before starting a patient on immunosuppression simply based on a test that detects these autoantibodies in the serum.
“Essentially, people tend to ‘treat antibodies,’ so to speak,” she said. “They look at serum and they see antibody seropositivity and they think it's an autoimmune disease and, ‘Now I have to go and start treating.’ And this is also published in case reports. People are even encouraged to do so. And I think it is not a good idea.
“We cannot make any conclusions that serum autoantibodies directed against brain antigens are disease--relevant, unless we have further supporting indication that they are. Of course they may be important for diagnosis of autoimmune diseases or as modulators of brain disease course, but then their presence in the CSF in high levels should also be confirmed.”
In the paper, the researchers wrote that “detection of substantial CSF AB [antibody] levels appears mandatory for allowing conclusions on a causal or symptom-aggravating association with any central nervous system disorder, such as any kind of encephalitis, epilepsy, psychosis, extrapyramidal symptoms, or cognitive decline.”
Previous studies have also found that brain antigen-directed autoantibodies are abundant in the serum of both diseased people and healthy controls. In a 2010 study published in the journal Brain Research, a research team at the University of Dentistry and Medicine of New Jersey found that 92 percent of all human sera contain brain-reactive autoantibodies.
