title: Specific antibody index in cerebrospinal fluid from patients with central and peripheral paraneoplastic neurological syndromes.
abstract: We evaluated the concentration of antineuronal antibodies in paired cerebrospinal fluid (CSF) and serum samples from 19 patients with central and peripheral paraneoplastic neurological syndromes (PNS), using an enzyme linked immunosorbent assay (ELISA) employing recombinant antineuronal antigens (HuD, Yo, Ri, CV2/CRMP5, amphiphysin, PNMA2/Ma2). The specific antibody index (AI) [Qspec/QIgG] was calculated to estimate specific intrathecal antibody synthesis. An AI>1.3 was considered as evidence of intrathecal specific antibody synthesis. 14 (88%) of 16 patients with exclusive or predominant paraneoplastic involvement of the central nervous system (CNS) showed an AI>1.3, indicating a specific intrathecal antibody synthesis, while all three patients with isolated involvement of the peripheral nervous system showed an AI<0.8. All together, in 17 of 19 patients (89%) we found a significant association (p<0.05) between central or peripheral neurological manifestations on the one hand and presence or absence of specific intrathecal synthesis respectively on the other hand. These data support the hypothesis that autoimmunity is involved in the pathogenesis of PNS.
authors.affiliation: Department of Neurology, Albert Ludwigs University, Freiburg, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Stich
authors.forename: Sven
authors.initials: S
authors.lastname: Jarius
authors.forename: Barbara
authors.initials: B
authors.lastname: Kleer
authors.forename: Christiane
authors.initials: C
authors.lastname: Rasiah
authors.forename: Raymond
authors.initials: R
authors.lastname: Voltz
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rauer
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000134:cerebrospinal fluid*; D000918:Antibody Specificity; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D020361:Paraneoplastic Syndromes, Nervous System / Q000134:cerebrospinal fluid* / Q000276:immunology*
chemical_list: D000906:Antibodies; D007074:Immunoglobulin G