Adenylate kinase 5 autoimmunity in treatment refractory limbic encephalitis.

Abstract

We report two men with limbic encephalitis (LE) refractory to corticosteroids, IVIg and plasma exchange. Both patients had serum/CSF antibodies that reacted with the cytoplasm of neurons. Probing of a hippocampal cDNA library resulted in the isolation of adenylate kinase 5 (AK5). Patients' antibodies, but not those of 111 controls, recognized AK5-expressing phage plaques. Human AK5-affinity purified antibodies reproduced the neuronal immunolabeling of patients' antibodies, and co-localized with a rabbit AK5 antibody, confirming that the brain autoantigen was AK5. Detection of antibodies to AK5 in LE patients carries a poor prognosis, and suggests the prompt use of aggressive immunosuppression.

• Authors: Erdem Tüzün, Jeffrey E Rossi, Steve F Karner, Alejandro F Centurion, Josep Dalmau
• Journal: Journal of neuroimmunology (J Neuroimmunol) Vol. 186 Issue 1-2 Pg. 177-80 (May 2007) ISSN: 0165-5728 [Print] Netherlands
• PMID: 17462746 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Immunoglobulins, Intravenous
• Isoenzymes
• Adenylate Kinase
• adenylate kinase 5

Topics

• Adenylate Kinase (blood, cerebrospinal fluid, immunology)
• Aged
• Animals
• Autoimmunity
• Gene Library
• Hippocampus (metabolism)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Isoenzymes (blood, cerebrospinal fluid, immunology)
• Limbic Encephalitis (blood, cerebrospinal fluid, pathology, therapy)
• Male
• Plasma Exchange (methods)
• Rats