RESUMEN
We present a case with subacute limbic encephalitis (LE) and thymoma. Neither classical onconeural antibodies nor antibodies to voltage gated potassium channels (VGKC) were detected, but the serum was positive for anti-glutamic acid decarboxylase (GAD). The patient serum also stained synaptic boutons of pyramidal cells and nuclei of granule cells of rat hippocampus. The objective of the study was to identify new antibodies associated with LE. Screening a cDNA expression library identified collapsin response mediator protein 3 (CRMP3), a protein involved in neurite outgrowth. The serum also reacted with both CRMP3 and CRMP4 by Western blot. Similar binding pattern of hippocampal granule cells was obtained with the patient serum and rabbit anti-serum against CRMP1-4. The CRMP1-4 antibodies stained neuronal nuclei of a biopsy from the patient's temporal lobe, but CRMP1-4 expression in thymoma could only be detected by immunoblotting. Absorption studies with recombinant GAD failed to abolish the staining of the hippocampal granule cells. Our findings illustrate that CRMP3-4 antibodies can be associated with LE and thymoma. This has previously been associated with CRMP5.
Asunto(s)
Autoanticuerpos/análisis , Encefalitis Límbica/etiología , Proteínas Musculares/inmunología , Timoma/complicaciones , Neoplasias del Timo/complicaciones , Animales , Western Blotting , Células Cultivadas , ADN Complementario/genética , Biblioteca de Genes , Hipocampo/inmunología , Humanos , Encefalitis Límbica/inmunología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuronas/inmunología , Síndromes Paraneoplásicos/etiología , Síndromes Paraneoplásicos/inmunología , Ratas , Lóbulo Temporal/inmunologíaRESUMEN
Morphological and immunological assays were employed to examine 18 epileptic patients and 40 Krushinskii-Molodkina rats undergoing subconvulsive and convulsive acoustic stimulations. After multiple audiogenic epileptiform convulsive fits the epileptogenic areas of the brain of epileptic patients (biopsy material) and the neocortex of the sensorimotor area, amygdaloid complex and hippocampus of rats manifested vascular alterations in the form of chronic or subacute vasculitis. The changes revealed in the ratio of B and T lymphocytes in the peripheral blood of the epileptic patients in combination with pronounced stimulation of cellular and humoral immunity responses to antigens of homologous and autologous brain extracts, more well-defined in marked inflammatory process, may attest to the immune genesis of endo- and perivasculitis.