CSF and serum immune parameters in Sydenham's chorea: evidence of an autoimmune syndrome?
Previous investigations have suggested that Sydenham's chorea (SC) may be an autoantibody mediated disorder. We examined this autoimmune hypothesis by measuring Th1 (IFN-gamma, IL-12) and Th2 (IL-4, IL-10) cytokines, oligoclonal bands (OCB) and anti-basal ganglia antibodies (ABGA). CSF IL-4 was elevated in 31% of acute SC and 50% of persistent SC. CSF IL-10 was also elevated in 31% of acute SC but 0% of persistent SC. CSF IFN-gamma was undetectable in all patients. Serums IL-4, IL-10 and IL-12 were elevated in acute compared to persistent SC. OCB were found in 46% of acute SC, ABGA were in 93% of acute SC and 50% of persistent SC was of IgG(1) and IgG(3) subclass. These findings support an autoantibody pathogenesis.
Church
Andrew J
AJ
Neuroimmunology Unit, Neuroinflammation Department, Institute of Neurology, Room 917, Queen Square, London WC1N 3BG, UK. A.Church@ion.ucl.ac.uk
Dale
Russell C
RC
Cardoso
Francisco
F
Candler
Paul M
PM
Chapman
Miles D
MD
Allen
Meredith L
ML
Klein
Nigel J
NJ
Lees
Andrew J
AJ
Giovannoni
Gavin
G
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood* / Q000134:cerebrospinal fluid*; D020274:Autoimmune Diseases of the Nervous System / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D001479:Basal Ganglia / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D002819:Chorea / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007136:Immunoglobulins / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology; D007378:Interleukins / Q000097:blood* / Q000134:cerebrospinal fluid*; D008297:Male; D043025:Oligoclonal Bands; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
D001323:Autoantibodies; D007074:Immunoglobulin G; D007136:Immunoglobulins; D007378:Interleukins; D043025:Oligoclonal Bands