Novel Autoantibodies in Idiopathic Small Fiber Neuropathy

Objective Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel hi...

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Published in:Annals of neurology Vol. 91; no. 1; pp. 66 - 77
Main Authors: Chan, Amanda C. Y., Wong, Hiu Yi, Chong, Yao Feng, Lai, Poh San, Teoh, Hock Luen, Ng, Alison Y. Y., Hung, Jennifer H. M., Chan, Yee Cheun, Ng, Kay W. P., Vijayan, Joy, Ong, Jonathan J. Y., Chandra, Bharatendu, Tan, Chi Hsien, Rutt, Nurul H., Tan, Ti Myen, Ismail, Nur Hafiza, Wilder‐Smith, Einar, Schwarz, Herbert, Choi, Hyungwon, Sharma, Vijay K., Mak, Anselm
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Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01-01-2022
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Abstract Objective Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel high‐throughput protein microarray platform that captures autoantibodies expressed in the native conformational state. Methods Sera from 58 SFN patients and 20 age‐ and gender‐matched healthy controls (HCs) were screened against >1,600 immune‐related antigens. Fluorescent unit readout and postassay imaging were performed, followed by composite data normalization and protein fold change (pFC) analysis. Analysis of an independent validation cohort of 33 SFN patients against the same 20 HCs was conducted to identify reproducible proteins in both cohorts. Results Nine autoantibodies were screened with statistical significance and pFC criteria in both cohorts, with at least 50% change in serum levels. Three proteins showed consistently high fold changes in main and validation cohorts: MX1 (FC = 2.99 and 3.07, respectively, p = 0.003, q = 0.076), DBNL (FC = 2.11 and 2.16, respectively, p = 0.009, q < 0.003), and KRT8 (FC = 1.65 and 1.70, respectively, p = 0.043, q < 0.003). Further subgroup analysis into iSFN and SFN by secondary causes (secondary SFN) in the main cohort showed that MX1 is higher in iSFN compared to secondary SFN (FC = 1.61 vs 0.106, p = 0.009). Interpretation Novel autoantibodies MX1, DBNL, and KRT8 are found in iSFN. MX1 may allow diagnostic subtyping of iSFN patients. ANN NEUROL 2022;91:66–77
AbstractList OBJECTIVESmall fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel high-throughput protein microarray platform that captures autoantibodies expressed in the native conformational state. METHODSSera from 58 SFN patients and 20 age- and gender-matched healthy controls (HCs) were screened against >1,600 immune-related antigens. Fluorescent unit readout and postassay imaging were performed, followed by composite data normalization and protein fold change (pFC) analysis. Analysis of an independent validation cohort of 33 SFN patients against the same 20 HCs was conducted to identify reproducible proteins in both cohorts. RESULTSNine autoantibodies were screened with statistical significance and pFC criteria in both cohorts, with at least 50% change in serum levels. Three proteins showed consistently high fold changes in main and validation cohorts: MX1 (FC = 2.99 and 3.07, respectively, p = 0.003, q = 0.076), DBNL (FC = 2.11 and 2.16, respectively, p = 0.009, q < 0.003), and KRT8 (FC = 1.65 and 1.70, respectively, p = 0.043, q < 0.003). Further subgroup analysis into iSFN and SFN by secondary causes (secondary SFN) in the main cohort showed that MX1 is higher in iSFN compared to secondary SFN (FC = 1.61 vs 0.106, p = 0.009). INTERPRETATIONNovel autoantibodies MX1, DBNL, and KRT8 are found in iSFN. MX1 may allow diagnostic subtyping of iSFN patients. ANN NEUROL 2022;91:66-77.
ObjectiveSmall fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel high‐throughput protein microarray platform that captures autoantibodies expressed in the native conformational state.MethodsSera from 58 SFN patients and 20 age‐ and gender‐matched healthy controls (HCs) were screened against >1,600 immune‐related antigens. Fluorescent unit readout and postassay imaging were performed, followed by composite data normalization and protein fold change (pFC) analysis. Analysis of an independent validation cohort of 33 SFN patients against the same 20 HCs was conducted to identify reproducible proteins in both cohorts.ResultsNine autoantibodies were screened with statistical significance and pFC criteria in both cohorts, with at least 50% change in serum levels. Three proteins showed consistently high fold changes in main and validation cohorts: MX1 (FC = 2.99 and 3.07, respectively, p = 0.003, q = 0.076), DBNL (FC = 2.11 and 2.16, respectively, p = 0.009, q < 0.003), and KRT8 (FC = 1.65 and 1.70, respectively, p = 0.043, q < 0.003). Further subgroup analysis into iSFN and SFN by secondary causes (secondary SFN) in the main cohort showed that MX1 is higher in iSFN compared to secondary SFN (FC = 1.61 vs 0.106, p = 0.009).InterpretationNovel autoantibodies MX1, DBNL, and KRT8 are found in iSFN. MX1 may allow diagnostic subtyping of iSFN patients. ANN NEUROL 2022;91:66–77
Objective Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel high‐throughput protein microarray platform that captures autoantibodies expressed in the native conformational state. Methods Sera from 58 SFN patients and 20 age‐ and gender‐matched healthy controls (HCs) were screened against >1,600 immune‐related antigens. Fluorescent unit readout and postassay imaging were performed, followed by composite data normalization and protein fold change (pFC) analysis. Analysis of an independent validation cohort of 33 SFN patients against the same 20 HCs was conducted to identify reproducible proteins in both cohorts. Results Nine autoantibodies were screened with statistical significance and pFC criteria in both cohorts, with at least 50% change in serum levels. Three proteins showed consistently high fold changes in main and validation cohorts: MX1 (FC = 2.99 and 3.07, respectively, p = 0.003, q = 0.076), DBNL (FC = 2.11 and 2.16, respectively, p = 0.009, q < 0.003), and KRT8 (FC = 1.65 and 1.70, respectively, p = 0.043, q < 0.003). Further subgroup analysis into iSFN and SFN by secondary causes (secondary SFN) in the main cohort showed that MX1 is higher in iSFN compared to secondary SFN (FC = 1.61 vs 0.106, p = 0.009). Interpretation Novel autoantibodies MX1, DBNL, and KRT8 are found in iSFN. MX1 may allow diagnostic subtyping of iSFN patients. ANN NEUROL 2022;91:66–77
Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in SFN, few autoantibodies have been described. We aimed to identify autoantibodies associated with idiopathic SFN (iSFN) by a novel high-throughput protein microarray platform that captures autoantibodies expressed in the native conformational state. Sera from 58 SFN patients and 20 age- and gender-matched healthy controls (HCs) were screened against >1,600 immune-related antigens. Fluorescent unit readout and postassay imaging were performed, followed by composite data normalization and protein fold change (pFC) analysis. Analysis of an independent validation cohort of 33 SFN patients against the same 20 HCs was conducted to identify reproducible proteins in both cohorts. Nine autoantibodies were screened with statistical significance and pFC criteria in both cohorts, with at least 50% change in serum levels. Three proteins showed consistently high fold changes in main and validation cohorts: MX1 (FC = 2.99 and 3.07, respectively, p = 0.003, q = 0.076), DBNL (FC = 2.11 and 2.16, respectively, p = 0.009, q < 0.003), and KRT8 (FC = 1.65 and 1.70, respectively, p = 0.043, q < 0.003). Further subgroup analysis into iSFN and SFN by secondary causes (secondary SFN) in the main cohort showed that MX1 is higher in iSFN compared to secondary SFN (FC = 1.61 vs 0.106, p = 0.009). Novel autoantibodies MX1, DBNL, and KRT8 are found in iSFN. MX1 may allow diagnostic subtyping of iSFN patients. ANN NEUROL 2022;91:66-77.
Author Tan, Chi Hsien
Rutt, Nurul H.
Tan, Ti Myen
Chan, Amanda C. Y.
Hung, Jennifer H. M.
Vijayan, Joy
Chandra, Bharatendu
Mak, Anselm
Wilder‐Smith, Einar
Sharma, Vijay K.
Ng, Kay W. P.
Ismail, Nur Hafiza
Ng, Alison Y. Y.
Lai, Poh San
Wong, Hiu Yi
Chong, Yao Feng
Choi, Hyungwon
Schwarz, Herbert
Teoh, Hock Luen
Chan, Yee Cheun
Ong, Jonathan J. Y.
AuthorAffiliation 9 Department of Neurology Inselspital Bern, University of Bern Bern Switzerland
10 Division of Rheumatology University Medicine Cluster, National University Health System Singapore
5 Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Pak Shek Kok China
1 Division of Neurology, Department of Medicine National University Health System Singapore
3 Department of Physiology, Yong Loo Lin School of Medicine National University of Singapore Singapore
4 Division of Life Science, State Key Laboratory of Molecular Neuroscience Hong Kong University of Science and Technology Clear Water Bay Hong Kong
2 Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore Singapore
8 Sengenics Singapore
6 Department of Pediatrics, Yong Loo Lin School of Medicine National University of Singapore Singapore
7 Division of Medical Genetics University of Iowa Iowa City IA USA
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PublicationYear 2022
Publisher John Wiley & Sons, Inc
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Snippet Objective Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically...
Small fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically important in...
ObjectiveSmall fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically...
OBJECTIVESmall fiber neuropathy (SFN) is clinically and etiologically heterogeneous. Although autoimmunity has been postulated to be pathophysiologically...
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StartPage 66
SubjectTerms Adult
Aged
Antigens
Autoantibodies
Autoantibodies - blood
Autoantibodies - immunology
Autoantigens - immunology
Autoimmunity
Cohort Studies
Etiology
Female
Fluorescence
Humans
Keratin-8 - immunology
Male
Microfilament Proteins - immunology
Middle Aged
Myxovirus Resistance Proteins - immunology
Neuropathy
Protein arrays
Protein folding
Proteins
Serum levels
Small Fiber Neuropathy - blood
Small Fiber Neuropathy - immunology
src Homology Domains - immunology
Subgroups
Title Novel Autoantibodies in Idiopathic Small Fiber Neuropathy
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fana.26268
https://www.ncbi.nlm.nih.gov/pubmed/34761434
https://www.proquest.com/docview/2611888382
https://search.proquest.com/docview/2596457033
https://pubmed.ncbi.nlm.nih.gov/PMC9300200
Volume 91
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