Autoantibodies are antibodies that the body makes against its own components and thereby cause diseases or symptoms. They play a role in a variety of neurologic disorders, including multiple sclerosis. Patients receiving interferon beta treatment for multiple sclerosis are prone to developing autoantibodies. -ed.
In this clinical summary, Dr. Durelli reviews the role of autoreactive antibodies in a number of neurologic conditions. The antibodies that are directly responsible for pathogenesis of neurologic diseases, such as acetylcholine receptor antibodies or anticardiolipin antibodies, are rare. Most often these autoantibodies are a marker for specific neurologic disorders, as seen in paraneoplastic syndromes. In multiple sclerosis, an autoimmune disease involving the CNS, specific autoantigens have not yet been identified. A variety of autoreactive antibodies, including anticardiolipin, antinuclear, anti-SSA, and antithyroid antibodies, which are usually associated with specific vasculitic or systemic syndromes, can, however, be found in multiple sclerosis patients. Antibodies to interferon occur in treated multiple sclerosis patients, and their role is not clear. Autoreactive antibodies found in polyneuropathies are rarely diagnostic, besides anti-GQ1b antibodies in Miller-Fisher syndrome and antimyelin-associated glycoprotein antibodies in chronic inflammatory demyelinating neuropathy with IgM monoclonal gammopathy of unknown significance. In paraneoplastic neurologic syndromes several autoreactive antibodies associated with onconeuronal intracellular or intranuclear antigens are often suggestive of a specific cancer. Their early detection and treatment of underlying tumor may lead to clinical improvement in some cases. On the other hand, auto-reactive antibodies against surface or synaptic antigens are specific of certain neurologic syndromes that often respond to immunosuppressive treatment.