van de Warrenburg Bart P C, Church Andrew J, Martino Davide, Candler Paul M, Bhatia Kailash P, Giovannoni Gavin, Quinn Niall P
Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, United Kingdom.
Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Mov Disord. 2008 May 15;23(7):958-963. doi: 10.1002/mds.21929.
Antineuronal antibodies (ANAs) have been implicated in the pathophysiology of postinfectious movement disorders, such as Sydenham's chorea. However, their relevance in other movement disorders--in the absence of infectious triggers--remains much disputed. We sought to assess the frequency of ANAs in idiopathic Parkinson's disease (IPD) and to explore whether a specific phenotype is associated with the presence of ANAs. For this purpose, we recruited 76 IPD patients, 9 patients with genetic parkinsonism, and 10 with one of the parkinson-plus syndromes. They were all subjected to a comprehensive clinical review. In addition, 50 patients with non-extrapyramidal neurological disease and 30 healthy blood donors served as control populations. Blood samples were tested for the presence of ANAs with Western blotting, using recombinant proteins of the three putative antigens (aldolase C, neuron-specific enolase, and pyruvate kinase M1). We found these antibodies in 11.8% of the 76 IPD patients, which differed significantly from healthy controls (0%, P = 0.043), but nonsignificantly from patients with genetic parkinsonism (11.1%), with a parkinson-plus syndrome (10%), or from neurological disease controls (4%). With respect to relevant disease characteristics, IPD patients with or without ANAs were indistinguishable, except for atypical disease features (mainly early falls or freezing and marked Pisa syndrome), which were more frequent in the ANA-positive IPD group. We conclude that ANAs do not play a role in the majority of patients with IPD, but might be relevant in the pathogenesis of IPD with atypical features.
抗神经元抗体（ANA）已被认为与感染后运动障碍（如 Sydenham 舞蹈病）的病理生理机制有关。然而，在没有感染诱因的情况下，它们在其他运动障碍中的相关性仍存在很大争议。我们试图评估特发性帕金森病（IPD）中 ANA 的频率，并探讨是否有特定表型与 ANA 的存在相关。为此，我们招募了 76 例 IPD 患者、9 例遗传性帕金森综合征患者和 10 例帕金森叠加综合征患者。他们均接受了全面的临床检查。此外，50 例非锥体外系神经疾病患者和 30 名健康献血者作为对照人群。使用三种假定抗原（醛缩酶 C、神经元特异性烯醇化酶和丙酮酸激酶 M1）的重组蛋白，通过蛋白质免疫印迹法检测血样中 ANA 的存在情况。我们在 76 例 IPD 患者中的 11.8%发现了这些抗体，这与健康对照组（0%，P = 0.043）有显著差异，但与遗传性帕金森综合征患者（11.1%）、帕金森叠加综合征患者（10%）或神经疾病对照组（4%）无显著差异。关于相关疾病特征，有或没有 ANA 的 IPD 患者没有区别，除了非典型疾病特征（主要是早期跌倒或冻结以及明显的 Pisa 综合征）在 ANA 阳性的 IPD 组中更常见。我们得出结论，ANA 在大多数 IPD 患者中不起作用，但可能与具有非典型特征的 IPD 的发病机制有关。
