Syuichi Tetsuka, Kaoru Tominaga, Eriko Ohta, Kenji Kuroiwa, Eiji Sakashita, Katsumi Kasashima, Toshiro Hamamoto, Michito Namekawa, Mitsuya Morita, Shinsuke Natsui, Tatsuo Morita, Keiko Tanaka, Yoshihisa Takiyama, Imaharu Nakano, Hitoshi Endo
JOURNAL OF THE NEUROLOGICAL SCIENCES 335(1-2) 48-57 2013年12月 査読有り
Onconeural immunity, a cancer-stimulated immune reaction that cross-reacts with neural tissues, is considered to be the principal pathological mechanism for paraneoplastic neurological syndromes (PNS). A common PNS is paraneoplastic cerebellar degeneration (PCD). We had encountered a PCD patient with urothelial carcinomas (UC) of the urinary bladder who was negative for the well-characterized PNS-related onconeural antibodies. In the present study, we aimed to identify a new PCD-related onconeural antibody, capable of recognizing both cerebellar neurons and cancer tissues from the patient, and applied a proteomic approach using mass spectrometry. We identified anti-creatine kinase, brain-type (CKB) antibody as a new autoantibody in the serum and cerebrospinal fluid from the patient. Immunohistochemistry indicated that anti-CKB antibody reacted with both cerebellar neurons and UC of the urinary bladder tissues. However, anti-CKB antibody was not detected in sera from over 30 donors, including bladder cancer patients without PCD, indicating that anti-CKB antibody is required for onset of PCD. We also detected anti-CKB antibody in sera from three other PCD patients. Our study demonstrated that anti-CKB antibody may be added to the list of PCD-related autoantibodies and may be useful for diagnosis of PCD. (C) 2013 Elsevier B.V. All rights reserved.