Cancer-associated retinopathy in patients with breast carcinoma.
BACKGROUND
Cancer-associated retinopathy (CAR) is a paraneoplastic neurological syndrome resulting in progressive loss of vision and clinical signs of retinal degeneration. It is associated with various types of cancer and is also considered to be an autoimmune disorder that involves cross-reaction between autoantibodies and retinal proteins. The aim of this study was to establish whether immunoreactivity to retinal antigens (RAs) observed in patients with breast cancer is accompanied by any visual impairments.


METHODS
Sera of 295 patients with diagnosed breast cancer were screened for the presence of anti-RAs antibodies using immunoblotting. Cellular immunoreactivity to RAs present in retinal extracts and to purified recoverin and arrestin was determined by means of a lymphocyte proliferation assay. Six patients with high-titer antibodies to RAs then underwent ophthalmic and neurological examinations.


RESULTS
Four serum samples contained high-titer antibodies to a 46-kDa protein, most probably retinal alpha-enolase, three had antibodies to a 48-kDa protein identified as retinal arrestin, while 56-, 43-, 41-, and 34-kDa antigens were recognized only by one serum sample each. Moreover, weak cellular response to all the RAs tested was observed in one patient and another patient responded only to retinal extract. Two of the examined patients displayed symptoms of CAR.


CONCLUSIONS
Immunoreactivity to RAs in patients with breast cancer may also be present in cases without clinical signs of CAR.
Department of Ophthalmology, Wrocław Medical University, Chałubińskiego 2a, 50-368, Wrocław, Poland. misiuk55@wp.pl
Marta
M
Misiuk-Hojło
Maria
M
Ejma
Wojciech A
WA
Gorczyca
Stanisław
S
Szymaniec
Danuta
D
Witkowska
Wojciech
W
Fortuna
Ryszard
R
Miedzybrodzki
Jadwiga
J
Rogozińska-Szczepka
Wiesława
W
Bartnik
D000368:Aged; D019393:Arrestin / Q000737:chemistry / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000276:immunology* / Q000503:physiopathology; D001943:Breast Neoplasms / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D004596:Electroretinography; D005074:Evoked Potentials, Visual; D005136:Eye Proteins / Q000737:chemistry / Q000276:immunology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008970:Molecular Weight; D009887:Ophthalmoscopy; D010257:Paraneoplastic Syndromes / Q000276:immunology* / Q000503:physiopathology; D010751:Phosphopyruvate Hydratase / Q000737:chemistry / Q000276:immunology*; D012164:Retinal Diseases / Q000276:immunology* / Q000503:physiopathology; D014786:Vision Disorders / Q000276:immunology* / Q000503:physiopathology; D014792:Visual Acuity; D014794:Visual Fields
D019393:Arrestin; D001323:Autoantibodies; D005136:Eye Proteins; D010751:Phosphopyruvate Hydratase