B and T cell imbalances in CSF of patients with Hu-antibody associated PNS.
In paraneoplastic neurological syndromes associated with Hu-antibodies (Hu-PNS) an important role for cellular immunity is hypothesized. We characterized the cerebrospinal fluid (CSF) pleocytosis in Hu-PNS patients by assessing the major lymphocyte subsets by flow cytometry. The B cell subset in the CSF of Hu-PNS patients showed a significant absolute (approximately 20x) and relative (approximately 3x) expansion, while the numbers of CD4+ T cells, CD8+ T cells and NK cells only showed an absolute expansion (approximately 4-7x) compared to the controls. On the other hand, the NKT cell subset showed a significant relative reduction in CSF and in blood of Hu-PNS patients. The relative B cell expansion is consistent with the intrathecal synthesis of Hu-antibodies, while the increased number of T and NK cells supports an additional role for cellular immunity in the pathogenesis of Hu-PNS. In addition, the autoimmune hypothesis of Hu-PNS is supported by the relative NKT cell deficiency.
de Graaf
Marieke
M
Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, The Netherlands.
de Beukelaar
Janet
J
Bergsma
Jelmer
J
Kraan
Jaco
J
van den Bent
Martin
M
Klimek
Markus
M
van Norden
Yvette
Y
Kusuma
Arinardi
A
Smitt
Peter Sillevis
PS
Gratama
Jan Willem
JW
D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000378:metabolism; D001402:B-Lymphocytes / Q000473:pathology*; D051959:ELAV Proteins / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D020361:Paraneoplastic Syndromes, Nervous System / Q000134:cerebrospinal fluid / Q000276:immunology / Q000473:pathology; D013601:T-Lymphocytes / Q000473:pathology*
D000906:Antibodies; D051959:ELAV Proteins