Yetimler Berrak, Tzartos John, Şengül Büşra, Dursun Erdinç, Ulukan Çağrı, Karagiorgou Katerina, Gezen-Ak Duygu, Sezgin Mine, Papaconstantinou Aliki, Tzartos Socrates, Orhan Elif Kocasoy, Ekizoğlu Esme, Küçükali Cem İsmail, Baykan Betül, Tüzün Erdem
Department of Neuroscience, Aziz Sancar Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey.
Tzartos NeuroDiagnostics, Athens, Greece.
Int J Neurosci. 2021 Aug;131(8):775-779. doi: 10.1080/00207454.2020.1758084. Epub 2020 Apr 28.
Idiopathic intracranial hypertension (IIH), a disease of obscure origin, is characterized by headache and visual disturbances due to increased intracranial pressure. Recent line of evidence has suggested involvement of inflammation in IIH pathogenesis thus bringing forward anti-glial autoimmunity as a potential contributor of IIH. Glial fibrillary acidic protein (GFAP) is a major astrocytic autoantigen associated with a specific form of meningoencephalitis.
In this study, we investigated the presence of GFAP-antibody in 65 sera (49 obtained during active disease and 16 during remission) and in 15 cerebrospinal fluid (CSF) samples of 58 consecutively recruited IIH patients using cell based assay and indirect immunohistochemistry.
GFAP-antibody was found in active period sera of 2 IIH patients with classical symptoms and good treatment response. Two remission period sera obtained at different time points from one of these cases showed lower titers of GFAP-antibody positivity. IgG from positive samples yielded an astrocytic immunoreactivity pattern. None of the CSF samples showed GFAP-antibodies.
These results suggest that anti-astrocyte autoimmunity might be present in a fraction of IIH patients. Exact pathogenic significance of this association needs to be further studied.
特发性颅内高压（IIH）是一种病因不明的疾病，其特征为因颅内压升高导致的头痛和视觉障碍。最近的一系列证据表明炎症参与了IIH的发病机制，从而提出抗神经胶质细胞自身免疫是IIH的一个潜在促成因素。胶质纤维酸性蛋白（GFAP）是一种与特定形式的脑膜脑炎相关的主要星形细胞自身抗原。
在本研究中，我们使用基于细胞的检测方法和间接免疫组织化学，对连续招募的58例IIH患者的65份血清（49份在疾病活动期获得，16份在缓解期获得）和15份脑脊液（CSF）样本中的GFAP抗体进行了检测。
在2例具有典型症状且治疗反应良好的IIH患者的活动期血清中发现了GFAP抗体。从其中1例患者在不同时间点获得的2份缓解期血清显示GFAP抗体阳性滴度较低。阳性样本中的IgG产生了星形细胞免疫反应模式。所有脑脊液样本均未显示GFAP抗体。
这些结果表明，一部分IIH患者可能存在抗星形细胞自身免疫。这种关联的确切致病意义需要进一步研究。
