title: Mitofilin and titin as target antigens in melanoma-associated retinopathy.
abstract: Melanoma-associated retinopathy (MAR) is a rare paraneoplastic syndrome in patients with melanoma. Since the onset of MAR symptoms is often associated with tumor progression or recrudescence of metastases, MAR-related symptoms are prognostic relevant. The pathomechanism underlying MAR is supposed to result from antibody production against yet unknown melanoma-associated antigens that are also expressed in retinal tissue, leading to the destruction of retinal cells and resulting in defective signal transduction. Only a 35 kDa protein in Müller glial cells, a 22 kDa neuronal antigen and retinal transducin have been identified as MAR-associated antigens to date. To identify additional antigens potentially involved in the pathogenesis of MAR, we screened a retina cDNA phage library for reactivity with antibodies in the sera from 9 patients with MAR or subclinical MAR using the serological analysis of recombinantly expressed clones (SEREX) approach. Six sera from melanoma patients without evidence of MAR and 10 sera from healthy donors served as controls. Mitofilin and titin were identified as antigens against which antibodies were found exclusively in sera of MAR patients, but not in the sera of MM patients without MAR or healthy donors. This is the first study to demonstrate that titin is highly expressed from retinal tissue and melanoma. The fact that none of the MAR-associated antigens detected to date by their capacity to elicit a humoral immune response is located on the cell surface questions a major pathogenetic role of the respective antibodies and suggests that cellular, rather than humoral mechanisms are operative in the primary immune attack against the retina in MAR.
authors.affiliation: Department of Dermatology, Saarland University Medical School, Homburg/Saar, Germany. hacpfo@uniklinik-saarland.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Pföhler
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Preuss
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Tilgen
authors.forename: Alexandra
authors.initials: A
authors.lastname: Stark
authors.forename: Evi
authors.initials: E
authors.lastname: Regitz
authors.forename: Natalie
authors.initials: N
authors.lastname: Fadle
authors.forename: Michael
authors.initials: M
authors.lastname: Pfreundschuh
mesh_terms: D000912:Antibodies, Neoplasm / Q000097:blood*; D000951:Antigens, Neoplasm / Q000235:genetics / Q000276:immunology*; D015152:Blotting, Northern; D045744:Cell Line, Tumor; D064211:Connectin; D018076:DNA, Complementary / Q000032:analysis; D004273:DNA, Neoplasm / Q000032:analysis; D015723:Gene Library; D006801:Humans; D007124:Immunoenzyme Techniques; D008545:Melanoma / Q000235:genetics / Q000276:immunology*; D024101:Mitochondrial Proteins / Q000235:genetics / Q000276:immunology*; D009124:Muscle Proteins / Q000235:genetics / Q000276:immunology*; D010257:Paraneoplastic Syndromes / Q000235:genetics / Q000276:immunology*; D019151:Peptide Library; D011494:Protein Kinases / Q000235:genetics / Q000276:immunology*; D012334:RNA, Neoplasm / Q000032:analysis; D012164:Retinal Diseases / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012698:Serologic Tests; D012878:Skin Neoplasms / Q000235:genetics / Q000276:immunology / Q000378:metabolism
chemical_list: D000912:Antibodies, Neoplasm; D000951:Antigens, Neoplasm; D064211:Connectin; D018076:DNA, Complementary; D004273:DNA, Neoplasm; C088548:IMMT protein, human; D024101:Mitochondrial Proteins; D009124:Muscle Proteins; D019151:Peptide Library; D012334:RNA, Neoplasm; C577285:TTN protein, human; D011494:Protein Kinases