A novel cell-based immunofluorescence assay for the detection of autoantibodies to myelin-associated glycoprotein

Sara Mariotto; Piera de Gaspari; Dominik Jäger; Stefanie Hahn; Cindy Forni; Sandra Saschenbrecker; Erik Lattwein; Alessandro Dinoto; Sergio Ferrari

doi:10.3389/fneur.2023.1289810

A novel cell-based immunofluorescence assay for the detection of autoantibodies to myelin-associated glycoprotein

Front Neurol. 2023 Dec 14:14:1289810. doi: 10.3389/fneur.2023.1289810. eCollection 2023.

Authors

Sara Mariotto¹, Piera de Gaspari², Dominik Jäger³, Stefanie Hahn³, Cindy Forni³, Sandra Saschenbrecker³, Erik Lattwein³, Alessandro Dinoto¹, Sergio Ferrari¹

Affiliations

¹ Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
² Neuroimmunology Group, Pediatric Research Institute, Padua, Italy.
³ Institute for Experimental Immunology, affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany.

Abstract

Peripheral neuropathy with antibodies to myelin-associated glycoprotein (MAG) is an autoimmune demyelinating disorder of the peripheral nervous system caused by pathogenic IgM recognizing the human natural killer-1 glycoepitope expressed on MAG. This study aimed to analyze the performance of a new indirect immunofluorescence cell-based assay (CBA, EUROIMMUN) for the detection of anti-MAG IgM. Antibody reactivity was determined in sera from 95 patients with clinical and neurophysiological evidence of anti-MAG-associated neuropathy and in control samples from 55 patients with other forms of peripheral neuropathy. Compared to the results of the gold standard method (ELISA, Bühlmann) and using samples at a dilution of 1:100, the CBA had a sensitivity of 98.9% and a specificity of 100% (PPV 100%, NPV 98.2%). In conclusion, the CBA allows the detection of antibodies to MAG using an easy and standardized technique, and it presents a sensitive and specific alternative to the more time-consuming ELISA. Larger studies are needed to address anti-MAG titer monitoring in parallel with clinical activity.

Keywords: HNK-1; IgM autoantibodies; MAG; cell-based assay; human natural killer-1; myelin-associated glycoprotein; neuropathy.

Grants and funding

This study was funded by EUROIMMUN Medizinische Labordiagnostika AG, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).