Humoral and cellular immune parameters before and during immunosuppressive therapy of a patient with stiff-man syndrome and insulin dependent diabetes mellitus. Issue 2 (1st August 1998)

• Record Type: Journal Article
• Authors: Hummel, M; Durinovic-Bello, I; Bonifacio, E; Lampasona, V; Endl, J; Fessele, S; Bergh, F Then; Trenkwalder, C; Standl, E; Ziegler, A-G
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 65:Issue 2(1998)
• Page Start: 204
• Page End: 208
• Publication Date: 1998-08-01
• Subjects: stiff-man syndrome -- T cell reactivity -- autoantibodies -- prednisolone therapy; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.65.2.204
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : OBJECTIVES: Humoral and cellular immune reactivity are reported for two neuroendocrine autoantigens—glutamic acid decarboxylase (GAD) and the protein tyrosine phosphatase IA-2—in a patient with the autoimmune type of stiff-man syndrome and insulin dependent diabetes (IDDM). METHODS: Antibodies and T cell proliferation against GAD and IA-2 and cytokine release of antigen stimulated T cells (IFN-γ) were determined before and several times during immunosuppressive therapy with prednisolone. RESULTS: Raised GAD antibodies against full length GAD65 or chimeric constructs were detected before therapy and they remained at a high concentration despite a marked clinical improvement during cortisone treatment. Antibodies to IA-2 were undetectable, but weak T cell responses to both GAD and IA-2 were seen before therapy and once on reduction of high cortisone dosages when the patient showed signs of clinical deterioration. Cytokine profiles showed increased IFN-γ production after stimulation with GAD or IA-2 suggesting increased activation of TH 1 cells. CONCLUSION: Immunosuppressive therapy —even with extremely high doses of 500 mg a day—does not lead to the reduction of antibody concentrations in the periphery nor to a switch in epitope recognition of such antibodies despite clinical improvement. The amount of T cell reactivity to various antigens, however, may be a useful marker to monitor the effectiveness of immunotherapy.