Humoral signatures of Caspr2-antibody spectrum disorder track with clinical phenotypes and outcomes.

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Tác giả: Omar Chuquisana, Juna M de Vries, Andre Dik, Jérôme Honnorat, Friederike Jönsson, Bastien Joubert, Stjepana Kovac, Gordan Lauc, Jan D Lünemann, Laura Marmolejo, Harald Prüss, Marianna Spatola, Paula Terroba-Navajas, Maarten J Titulaer, Heinz Wiendl

Ngôn ngữ: eng

Ký hiệu phân loại: 355.123 Morale and motivation

Thông tin xuất bản: United States : Med (New York, N.Y.) , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 89432

BACKGROUND: Immunoglobulin (Ig) G4 auto-antibodies (Abs) against contactin-associated protein-like 2 (Caspr2), a transmembrane cell adhesion protein expressed in the central and peripheral nervous system, are found in patients with a broad spectrum of neurological symptoms. While the adoptive transfer of Caspr2-specific IgG induces brain pathology in susceptible rodents, the mechanisms by which Caspr2-Abs mediate neuronal dysfunction and translate into clinical syndromes are incompletely understood. METHODS: We use a systems-level approach combined with high-dimensional characterization of Ab-associated immune features to deeply profile humoral biosignatures in patients with Caspr2-Ab-associated neurological syndromes. FINDINGS: We identify two signatures strongly associated with two major clinical phenotypes, limbic encephalitis (LE) and predominant peripheral nerve hyperexcitability without LE (non-LE). Caspr2-IgG Fc-driven pro-inflammatory features, characterized by increased binding affinities for activating Fcγ receptors (FcγRs) and C1q, along with a higher prevalence of IgG1-class Abs, in addition to IgG4, are strongly associated with LE. Both the occurrence of Caspr2-specific IgG1 and higher serum levels of interleukin (IL)-6 and IL-15, along with increased concentrations of biomarkers reflecting neuronal damage and glial cell activation, are associated with poorer clinical outcomes at 1-year follow-up. CONCLUSIONS: The presence of IgG1 isotypes and Fc-mediated effector functions control the pathogenicity of Caspr2-specific Abs to induce LE. Biologics targeting FcR function might potentially restrain Caspr2-Ab-induced pathology and improve clinical outcomes. FUNDING: This study was funded by a German-French joint research program supported by the German Research Foundation (DFG) and the Agence Nationale de la Recherche (ANR) and by the Interdisciplinary Centre for Clinical Research (IZKF) Münster.
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