Harry Alexopoulos1, Marinos C Dalakas. 1. Neuroimmunology Unit, Department of Pathophysiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
BACKGROUND: Stiff Person Syndrome (SPS) is a relatively rare but often overlooked autoimmune neurological disorder that targets antigens within the brain's inhibitory pathways resulting in incapacitating stiffness and spasms that impact on the patients' quality of life. Although a number of immunomodulating therapies significantly improve the patients' symptoms, the exact pathogenic mechanisms remain unclear. MATERIALS AND METHODS: The current literature on SPS was reviewed and combined with the authors' experience with many patients and various laboratory studies. The majority of the patients have high-titre anti-GAD (Glutamic Acid Decarboxylase) antibodies in the sera and CSF suggesting dysfunction of the GABAergic neurotransmission. These antibodies are excellent disease markers but their pathogenic role remains uncertain. CONCLUSIONS: This review provides a critical assessment on the immunobiology of SPS, describes the identification of anti-GABARAP antibodies as a new antigenic target in the GABAergic synapse and identifies the areas for future research.
BACKGROUND: Stiff Person Syndrome (SPS) is a relatively rare but often overlooked autoimmune neurological disorder that targets antigens within the brain's inhibitory pathways resulting in incapacitating stiffness and spasms that impact on the patients' quality of life. Although a number of immunomodulating therapies significantly improve the patients' symptoms, the exact pathogenic mechanisms remain unclear. MATERIALS AND METHODS: The current literature on SPS was reviewed and combined with the authors' experience with many patients and various laboratory studies. The majority of the patients have high-titre anti-GAD (Glutamic Acid Decarboxylase) antibodies in the sera and CSF suggesting dysfunction of the GABAergic neurotransmission. These antibodies are excellent disease markers but their pathogenic role remains uncertain. CONCLUSIONS: This review provides a critical assessment on the immunobiology of SPS, describes the identification of anti-GABARAP antibodies as a new antigenic target in the GABAergic synapse and identifies the areas for future research.
Authors: Marinos C Dalakas; Goran Rakocevic; James M Dambrosia; Harry Alexopoulos; Beverly McElroy Journal: Ann Neurol Date: 2017-08-09 Impact factor: 10.422
Authors: Thashi Chang; Haris Alexopoulos; Mary McMenamin; Alexander Carvajal-González; Sian K Alexander; Robert Deacon; Ferenc Erdelyi; Gabor Szabó; Szabó Gabor; Bethan Lang; Franz Blaes; Peter Brown; Angela Vincent Journal: JAMA Neurol Date: 2013-09-01 Impact factor: 18.302