Clinical significance of cation channel antibodies in motor neuron disease

Muscle Nerve. 2016 Aug;54(2):228-31. doi: 10.1002/mus.25046. Epub 2016 Feb 9.

Abstract

Introduction: Antibodies against cation channels, including voltage-gated potassium channel (VGKC) complex, voltage-gated calcium channel (VGCC), and ganglionic acetylcholine receptor (gAChR), are detected in subgroups of autoimmune disorders, and rarely occur in motor neuron disease (MND).

Methods: This investigation was a case-control study of 28 MND patients positive for cation channel antibodies in comparison with 56 age/gender/onset/diagnostic-category-matched MND patients without such antibodies.

Results: One or more cation channel antibodies were detected in 6.9% of MND patients, mostly at low titers. The rate of MND progression determined by the revised ALS Functional Rating Scale-revised (ALSFRS-R) and Kaplan-Meier survival analysis was statistically indistinguishable between the antibody-positive and control groups. Incidence rates of cancer and coexisting autoimmune disorders were similar between both groups, based on non-comprehensive screening.

Conclusion: Cation channel antibodies in MND patients do not appear to affect disease progression. Routine testing for paraneoplastic antibodies is probably of limited usefulness in most MND patients. Muscle Nerve 54: 228-231, 2016.

Keywords: amyotrophic lateral sclerosis; autoimmunity; ganglionic acetylcholine receptor antibody; motor neuron disease; voltage-gated calcium channel antibody; voltage-gated potassium channel complex antibody.

MeSH terms

  • Autoantibodies / blood*
  • Case-Control Studies
  • Female
  • Humans
  • Ion Channels / immunology*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Motor Neuron Disease / blood*
  • Motor Neuron Disease / immunology
  • Motor Neuron Disease / mortality
  • Retrospective Studies

Substances

  • Autoantibodies
  • Ion Channels