title: Gilles de la Tourette syndrome is not linked to contactin-associated protein receptor 2 antibodies.
abstract: BACKGROUND
  In Gilles de la Tourette syndrome (GTS) an immunopathogenic influence of autoantibodies is suspected. In familial GTS a disruption of the contactin-associated protein 2 gene (CNTNAP2), coding for the contactin-associated protein 2 (CASPR2), has been reported. Autoantibodies against CASPR2 are associated with other movement disorders like Morvan's syndrome. In addition, positive oligoclonal bands (OCB) in cerebrospinal fluid (CSF) have been found in more than a third of GTS patients, indicating a pathological intrathecal immunoglobulin synthesis. These findings drove the hypothesis that CASPR2 antibodies are involved in GTS.
  
  
  METHODS
  In this cross sectional study, 51 patients with GTS were examined for CASPR2 and other autoantibodies. We used indirect immunofluorescence or enzyme-linked visualization in cell-based assays on tissue sections from cerebellum (rat and monkey), hippocampus (rat), and immunoblots for the detection of specific or any other autoantibodies.
  
  
  RESULTS
  Serum samples from 51 GTS patients, mean age 35.0 ± 13.1 y, were analyzed. In none of the 51 GTS sera CASPR2 antibodies were detectable. Neither had we found any other specific autoantibodies (LGI1, NMDAR, AMPA1, AMPA/2 or GABAB1/B2). An anti-nuclear pattern of immunoreactivity was observed in 7/51 (14 %) samples. In these patients an immunoblot analysis was used to rule out antibodies directed against well-defined intracellular target antigens. A specific anti-neuronal binding pattern could not be seen in any of the tissue sections.
  
  
  CONCLUSIONS
  The results negate that CASPR2 antibodies play a role in the pathogenesis of Tourette syndrome and do not support the assumption that anti-neuronal antibodies are involved.
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. suehs.kurt-wolfram@mh-hannover.de.
authors.forename: Kurt-Wolfram
authors.initials: KW
authors.lastname: Sühs
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. skripuletz.thomas@mh-hannover.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Skripuletz
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. pul.refik@mh-hannover.de.
authors.forename: Refik
authors.initials: R
authors.lastname: Pul
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Alvermann.Sascha@mh-hannover.de.
authors.forename: Sascha
authors.initials: S
authors.lastname: Alvermann
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Schwenkenbecher.Philipp@mh-hannover.de.
authors.forename: Philipp
authors.initials: P
authors.lastname: Schwenkenbecher
authors.affiliation: Klinik für Neurologie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Stangel.Martin@mh-hannover.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Stangel
authors.affiliation: Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Mueller-Vahl.Kirsten@mh-hannover.de.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Müller-Vahl
mesh_terms: D000328:Adult; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D057809:HEK293 Cells; D000882:Haplorhini; D006624:Hippocampus / Q000378:metabolism; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000276:immunology*; D009419:Nerve Tissue Proteins / Q000276:immunology*; D051381:Rats; D005879:Tourette Syndrome / Q000097:blood* / Q000276:immunology*; D014162:Transfection
chemical_list: D001323:Autoantibodies; C403049:CNTNAP2 protein, human; D008565:Membrane Proteins; D009419:Nerve Tissue Proteins