Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies

Silvia Graciela Ramos; Viviana Novoa; Claudio Aranda

doi:doi:10.11648/j.iji.20241202.12

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Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies

Silvia Graciela Ramos^*

, Viviana Novoa

, Claudio Aranda

Published in International Journal of Immunology (Volume 12, Issue 2)

Received: 20 June 2024 Accepted: 8 July 2024 Published: 23 July 2024

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Abstract

Introduction: Autoimmune epilepsy remains under-recognized, and its true incidence remains uncertain. Objective: This study aimed to determine the prevalence of neuronal autoantibodies in patients with epilepsy of unknown etiology. Materials and Methods: An observational, longitudinal, prospective, and analytical study was conducted to assess the presence of autoantibodies associated with autoimmune encephalitis, glutamic acid decarboxylase-65 (GAD65), and onconeural antibodies in the serum and cerebrospinal fluid of consecutive patients with epilepsy of unknown etiology. Results: Sixty patients and 80 controls (30 healthy individuals, 30 with multiple sclerosis, 10 with systemic lupus erythematosus, and 10 with Sjögren's syndrome) were included to detect neuronal antibodies. Among epilepsy patients, 28 out of 60 (47%) tested positive for antibodies against N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), and glutamic acid decarboxylase (GAD), which was significantly higher (p < 0.001) than in the combined control cohort. No onconeural antibodies were detected in epilepsy patients except for 6 cases of epilepsy, 1 case of multiple sclerosis, and 3 cases of lupus with positive GAD by immunofluorescence assay and immunoblotting. There was no significant difference in antibody incidence between male and female epilepsy patients. The incidence of positive autoantibodies was significantly higher in patients with focal epilepsy compared to those with generalized epilepsy (p < 0.01). Conclusions: The findings indicate the presence of antibodies against NMDAR, VGKC-associated proteins (LGI1, CASPR2), and intracellular antigens (GAD65) in the serum and cerebrospinal fluid of patients with epilepsy, suggesting an autoimmune etiology. These results underscore the need for further research to elucidate the role of autoantibodies in epilepsy pathogenesis and to explore immunotherapeutic interventions.

Published in	International Journal of Immunology (Volume 12, Issue 2)
DOI	10.11648/j.iji.20241202.12
Page(s)	30-37
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Established Epilepsy, New-Onset Epilepsy, Neuronal Autoantibodies, Voltage-Gated Potassium Channel Complex, Glutamic Acid Decarboxylase, NMDA Receptor

References

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[12]	Niehusmann P, Dalmau J, Rudlowski C, Vincent A, Elger CE, Rossi JE, et al. Diagnostic value of N-methyl-D-aspartate receptor antibodies in women with new-onset epilepsy. Arch Neurol 2009 66: 458–464. https://doi.org/10.1001/archneurol.2009.5
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[21]	Gresa-Arribas N, Titulaer MJ, Torrents A, et al. Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol 2014; 13: 167-77. https://doi.org/10.1016/S1474-4422(13)70282-5
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APA Style

Ramos, S. G., Novoa, V., Aranda, C. (2024). Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. International Journal of Immunology, 12(2), 30-37. https://doi.org/10.11648/j.iji.20241202.12

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ACS Style

Ramos, S. G.; Novoa, V.; Aranda, C. Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. Int. J. Immunol. 2024, 12(2), 30-37. doi: 10.11648/j.iji.20241202.12

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AMA Style

Ramos SG, Novoa V, Aranda C. Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. Int J Immunol. 2024;12(2):30-37. doi: 10.11648/j.iji.20241202.12

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@article{10.11648/j.iji.20241202.12,
  author = {Silvia Graciela Ramos and Viviana Novoa and Claudio Aranda},
  title = {Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies
},
  journal = {International Journal of Immunology},
  volume = {12},
  number = {2},
  pages = {30-37},
  doi = {10.11648/j.iji.20241202.12},
  url = {https://doi.org/10.11648/j.iji.20241202.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20241202.12},
  abstract = {Introduction: Autoimmune epilepsy remains under-recognized, and its true incidence remains uncertain. Objective: This study aimed to determine the prevalence of neuronal autoantibodies in patients with epilepsy of unknown etiology. Materials and Methods: An observational, longitudinal, prospective, and analytical study was conducted to assess the presence of autoantibodies associated with autoimmune encephalitis, glutamic acid decarboxylase-65 (GAD65), and onconeural antibodies in the serum and cerebrospinal fluid of consecutive patients with epilepsy of unknown etiology. Results: Sixty patients and 80 controls (30 healthy individuals, 30 with multiple sclerosis, 10 with systemic lupus erythematosus, and 10 with Sjögren's syndrome) were included to detect neuronal antibodies. Among epilepsy patients, 28 out of 60 (47%) tested positive for antibodies against N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), and glutamic acid decarboxylase (GAD), which was significantly higher (p < 0.001) than in the combined control cohort. No onconeural antibodies were detected in epilepsy patients except for 6 cases of epilepsy, 1 case of multiple sclerosis, and 3 cases of lupus with positive GAD by immunofluorescence assay and immunoblotting. There was no significant difference in antibody incidence between male and female epilepsy patients. The incidence of positive autoantibodies was significantly higher in patients with focal epilepsy compared to those with generalized epilepsy (p < 0.01). Conclusions: The findings indicate the presence of antibodies against NMDAR, VGKC-associated proteins (LGI1, CASPR2), and intracellular antigens (GAD65) in the serum and cerebrospinal fluid of patients with epilepsy, suggesting an autoimmune etiology. These results underscore the need for further research to elucidate the role of autoantibodies in epilepsy pathogenesis and to explore immunotherapeutic interventions.
},
 year = {2024}
}

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TY  - JOUR
T1  - Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies

AU  - Silvia Graciela Ramos
AU  - Viviana Novoa
AU  - Claudio Aranda
Y1  - 2024/07/23
PY  - 2024
N1  - https://doi.org/10.11648/j.iji.20241202.12
DO  - 10.11648/j.iji.20241202.12
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 30
EP  - 37
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20241202.12
AB  - Introduction: Autoimmune epilepsy remains under-recognized, and its true incidence remains uncertain. Objective: This study aimed to determine the prevalence of neuronal autoantibodies in patients with epilepsy of unknown etiology. Materials and Methods: An observational, longitudinal, prospective, and analytical study was conducted to assess the presence of autoantibodies associated with autoimmune encephalitis, glutamic acid decarboxylase-65 (GAD65), and onconeural antibodies in the serum and cerebrospinal fluid of consecutive patients with epilepsy of unknown etiology. Results: Sixty patients and 80 controls (30 healthy individuals, 30 with multiple sclerosis, 10 with systemic lupus erythematosus, and 10 with Sjögren's syndrome) were included to detect neuronal antibodies. Among epilepsy patients, 28 out of 60 (47%) tested positive for antibodies against N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), and glutamic acid decarboxylase (GAD), which was significantly higher (p < 0.001) than in the combined control cohort. No onconeural antibodies were detected in epilepsy patients except for 6 cases of epilepsy, 1 case of multiple sclerosis, and 3 cases of lupus with positive GAD by immunofluorescence assay and immunoblotting. There was no significant difference in antibody incidence between male and female epilepsy patients. The incidence of positive autoantibodies was significantly higher in patients with focal epilepsy compared to those with generalized epilepsy (p < 0.01). Conclusions: The findings indicate the presence of antibodies against NMDAR, VGKC-associated proteins (LGI1, CASPR2), and intracellular antigens (GAD65) in the serum and cerebrospinal fluid of patients with epilepsy, suggesting an autoimmune etiology. These results underscore the need for further research to elucidate the role of autoantibodies in epilepsy pathogenesis and to explore immunotherapeutic interventions.

VL  - 12
IS  - 2
ER  -

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Author Information

Silvia Graciela Ramos

Immunology Laboratory Section, Central Laboratory Division, Hospital Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina

Contact Email

http://orcid.org/0000-0003-4028-8363
Viviana Novoa

Immunology Laboratory Section, Central Laboratory Division, Hospital Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina

Contact Email

http://orcid.org/0000-0002-5179-3229
Claudio Aranda

Immunology Laboratory Section, Central Laboratory Division, Hospital Carlos G. Durand, Ciudad Autónoma de Buenos Aires, Argentina

Contact Email

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Plain Text BibTeX RIS

APA Style

Ramos, S. G., Novoa, V., Aranda, C. (2024). Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. International Journal of Immunology, 12(2), 30-37. https://doi.org/10.11648/j.iji.20241202.12

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ACS Style

Ramos, S. G.; Novoa, V.; Aranda, C. Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. Int. J. Immunol. 2024, 12(2), 30-37. doi: 10.11648/j.iji.20241202.12

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AMA Style

Ramos SG, Novoa V, Aranda C. Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies. Int J Immunol. 2024;12(2):30-37. doi: 10.11648/j.iji.20241202.12

Copy | Download

@article{10.11648/j.iji.20241202.12,
  author = {Silvia Graciela Ramos and Viviana Novoa and Claudio Aranda},
  title = {Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies
},
  journal = {International Journal of Immunology},
  volume = {12},
  number = {2},
  pages = {30-37},
  doi = {10.11648/j.iji.20241202.12},
  url = {https://doi.org/10.11648/j.iji.20241202.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20241202.12},
  abstract = {Introduction: Autoimmune epilepsy remains under-recognized, and its true incidence remains uncertain. Objective: This study aimed to determine the prevalence of neuronal autoantibodies in patients with epilepsy of unknown etiology. Materials and Methods: An observational, longitudinal, prospective, and analytical study was conducted to assess the presence of autoantibodies associated with autoimmune encephalitis, glutamic acid decarboxylase-65 (GAD65), and onconeural antibodies in the serum and cerebrospinal fluid of consecutive patients with epilepsy of unknown etiology. Results: Sixty patients and 80 controls (30 healthy individuals, 30 with multiple sclerosis, 10 with systemic lupus erythematosus, and 10 with Sjögren's syndrome) were included to detect neuronal antibodies. Among epilepsy patients, 28 out of 60 (47%) tested positive for antibodies against N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), and glutamic acid decarboxylase (GAD), which was significantly higher (p < 0.001) than in the combined control cohort. No onconeural antibodies were detected in epilepsy patients except for 6 cases of epilepsy, 1 case of multiple sclerosis, and 3 cases of lupus with positive GAD by immunofluorescence assay and immunoblotting. There was no significant difference in antibody incidence between male and female epilepsy patients. The incidence of positive autoantibodies was significantly higher in patients with focal epilepsy compared to those with generalized epilepsy (p < 0.01). Conclusions: The findings indicate the presence of antibodies against NMDAR, VGKC-associated proteins (LGI1, CASPR2), and intracellular antigens (GAD65) in the serum and cerebrospinal fluid of patients with epilepsy, suggesting an autoimmune etiology. These results underscore the need for further research to elucidate the role of autoantibodies in epilepsy pathogenesis and to explore immunotherapeutic interventions.
},
 year = {2024}
}

Copy | Download

TY  - JOUR
T1  - Link Between Autoimmunity and Epilepsy: Neuronal Autoantibodies

AU  - Silvia Graciela Ramos
AU  - Viviana Novoa
AU  - Claudio Aranda
Y1  - 2024/07/23
PY  - 2024
N1  - https://doi.org/10.11648/j.iji.20241202.12
DO  - 10.11648/j.iji.20241202.12
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 30
EP  - 37
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20241202.12
AB  - Introduction: Autoimmune epilepsy remains under-recognized, and its true incidence remains uncertain. Objective: This study aimed to determine the prevalence of neuronal autoantibodies in patients with epilepsy of unknown etiology. Materials and Methods: An observational, longitudinal, prospective, and analytical study was conducted to assess the presence of autoantibodies associated with autoimmune encephalitis, glutamic acid decarboxylase-65 (GAD65), and onconeural antibodies in the serum and cerebrospinal fluid of consecutive patients with epilepsy of unknown etiology. Results: Sixty patients and 80 controls (30 healthy individuals, 30 with multiple sclerosis, 10 with systemic lupus erythematosus, and 10 with Sjögren's syndrome) were included to detect neuronal antibodies. Among epilepsy patients, 28 out of 60 (47%) tested positive for antibodies against N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2), leucine-rich glioma-inactivated 1 (LGI1), and glutamic acid decarboxylase (GAD), which was significantly higher (p < 0.001) than in the combined control cohort. No onconeural antibodies were detected in epilepsy patients except for 6 cases of epilepsy, 1 case of multiple sclerosis, and 3 cases of lupus with positive GAD by immunofluorescence assay and immunoblotting. There was no significant difference in antibody incidence between male and female epilepsy patients. The incidence of positive autoantibodies was significantly higher in patients with focal epilepsy compared to those with generalized epilepsy (p < 0.01). Conclusions: The findings indicate the presence of antibodies against NMDAR, VGKC-associated proteins (LGI1, CASPR2), and intracellular antigens (GAD65) in the serum and cerebrospinal fluid of patients with epilepsy, suggesting an autoimmune etiology. These results underscore the need for further research to elucidate the role of autoantibodies in epilepsy pathogenesis and to explore immunotherapeutic interventions.

VL  - 12
IS  - 2
ER  -

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