Abundant glutamic acid decarboxylase (GAD)-reactive B cells in gad-antibody-associated neurological disorders.

Thaler, Franziska S.; Thaller, Anna L.; Biljecki, Michelle; Schuh, Elisabeth; Winklmeier, Stephan; Mahler, Christoph F.; Gerhards, Ramona; Völk, Stefanie; Schnorfeil, Frauke; Subklewe, Marion; Hohlfeld, Reinhard; Kümpfel, Tania; Meinl, Edgar

High levels of antibodies against glutamic acid decarboxylase (GAD) are observed in patients with different neurological disorders, but cells producing these autoantibodies are largely unexplored. We detect circulating GAD-reactive B cells in peripheral blood that readily differentiate into antibody-producing cells. These cells are highly elevated in most patients with GAD-antibody-associated disorders (n = 15) compared to controls (n = 19). They mainly produce GAD65 antibodies of the IgG1 and IgG4 subclasses and are as abundant as B cells reactive for common recall antigens. Bone marrow cells represent an additional source of GAD antibodies. The identification of GAD-antibody-producing cells has implications for the selection of cell-specific biologics. ANN NEUROL 2019;85:448-454.

GLUTAMATE decarboxylase; BONE marrow cells; IMMUNOGLOBULIN producing cells; B cells; BLOOD cells; AUTOANTIBODIES; BONE marrow; CEREBELLAR ataxia; COMPARATIVE studies; ENCEPHALITIS; ENZYMES; IMMUNOGLOBULINS; RESEARCH methodology; MEDICAL cooperation; RESEARCH; STIFF-person syndrome; EVALUATION research; CASE-control method; MONONUCLEAR leukocytes

Annals of Neurology, 2019, Vol 85, Issue 3, p448

0364-5134

Academic Journal

10.1002/ana.25414