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Autoantikörperdiagnostik in der Neurologie mittels nativer und rekombinanter Antigensubstrate

Autoantibody diagnostics in neurology using native and recombinant antigenic substrates

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Zusammenfassung

Die moderne Diagnostik neurologisch relevanter Autoantikörper basiert auf der indirekten Immunfluoreszenz mit Gefrierschnitten von Hippokampus, Kleinhirn und anderen Geweben. Dem monospezifischen Nachweis dienen zusätzlich HEK-Zellen („human embryonic kidney cells“), die mit unterschiedlichen neuralen Antigenen transfiziert sind. Einen schnellen Überblick verschafft man sich mit Biochip-Mosaiken: 20 oder mehr Substrate werden auf einem Reaktionsfeld nebeneinander angeordnet und mit der Probe (Serum oder Liquor) inkubiert. Ergänzend verwendet man Westernblots auf der Basis von Kleinhirn- und Hippokampusextrakten oder Linienblots mit definierten rekombinanten Antigenen. Initial sollte man die wichtigsten antineuralen Autoantikörper parallel untersuchen und sich nicht auf die Analyse von Einzelparametern beschränken. Bis vor wenigen Jahren wurden vorwiegend Autoantikörper gegen intrazelluläre neuronale Antigene untersucht. Weitaus häufiger findet man aber Antikörper gegen Strukturen der neuralen Zelloberfläche, insbesondere gegen Glutamatrezeptoren (Typ NMDA).

Summary

Modern diagnostics for the determination of neurologically relevant autoantibodies are based on indirect immunofluorescence using tissue sections of the hippocampus, cerebellum and other tissues. For monospecific detection human embryonic kidney (HEK) cells transfected with different neurological antigens are used. Biochip mosaics are designed to give a quick overview and contain 20 or more substances positioned next to each other on a reaction field, which are incubated with the serum or cerebrospinal fluid (CSF) sample. Western blots based on cerebellum or hippocampus extracts or line blots containing defined recombinant antigens are used additionally. Initial investigations should always comprise the parallel analysis of all major antineural autoantibodies instead of performing only single parameter tests. Up until a few years ago autoantibodies against intracellular neuronal antigens were mainly investigated. Antibodies against structures of the neural cell surface, however, are much more frequently found, especially those against glutamate receptors (type NMDA).

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Die Autoren sind Angestellte (SS, KR, CP, LK) bzw. Vorstandsmitglied (WS) der Euroimmun AG. Euroimmun entwickelt und vertreibt Testsysteme für den Nachweis von Autoantikörpern.

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Authors and Affiliations

  1. Institut für Experimentelle Immunologie, Euroimmun, Seekamp 31, 23560, Lübeck, Deutschland

    W. Stöcker, S. Saschenbrecker, K. Rentzsch, L. Komorowski & C. Probst

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  1. W. Stöcker
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  2. S. Saschenbrecker
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  3. K. Rentzsch
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  4. L. Komorowski
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  5. C. Probst
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Correspondence to W. Stöcker.

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Stöcker, W., Saschenbrecker, S., Rentzsch, K. et al. Autoantikörperdiagnostik in der Neurologie mittels nativer und rekombinanter Antigensubstrate. Nervenarzt 84, 471–476 (2013). https://doi.org/10.1007/s00115-012-3607-5

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  • DOI: https://doi.org/10.1007/s00115-012-3607-5

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