Onconeural antigen spreading in paraneoplastic neurological disease due to small cell lung cancer

Oxford Medical Case Reports
Andre DikNico Melzer

Abstract

Cellular and humoral immunity towards distinct onconeural antigens is the hallmark of paraneoplastic neurological diseases (PNDs). Stable formation of immunoglobulin (Ig) G antibodies to particular onconeural antigens occurs in the majority of cases, whereas persistent coexistence of antibodies specific for multiple onconeural antigens is a relatively rare phenomenon of certain malignant tumors like small cell lung cancer (SCLC). We here describe onconeural antigen spreading in a 70-year-old Caucasian male with PND due to SCLC. Onconeural antigen spreading may be promoted by two mutually non-exclusive mechanisms: (i) a switch of antigen expression pattern of the underlying tumor tissue as a result of a mutagenic process caused by the cancer itself and (ii) a self-propagated paraneoplastic immune response with persistent neuronal destruction, liberation, processing and presentation of intracellular neural antigens. This illustrates a potential dissociation between peripheral anti-tumoral immunity and central anti-neural immunity during the course of PND.

References

Oct 7, 2004·Annals of Neurology·Sean J PittockVanda A Lennon
Sep 23, 2011·Acta Neuropathologica·Andrew McKeon, Sean J Pittock
Jul 31, 2013·Immunity·Daniel S Chen, Ira Mellman
May 17, 2014·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Erika S HortaSean J Pittock
May 24, 2016·Neurology. Neuroimmunology and Neuroinflammation·Kristin S GolombeckNico Melzer

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Citations

Oct 9, 2020·Journal of Clinical Neurology·Xuan SunZhenfu Wang

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