Response to: Neurofascin-155 as a putative antigen in combined central and peripheral demyelination
EdgarMeinl, Institute of Clinical Neuroimmunology, Biomedical Center and University Hospital, Ludwig Maximilianedgar.meinl@med.uni-muenchen.de
Atay Vural, Planegg, Germany
Submitted August 01, 2016
We read with interest the Clinical/Scientific Note by Cortese et al. reporting the absence of antibodies to neurofascin-155 (NF155) in 16 patients with combined central and peripheral demyelination (CCPD). [1] This report is in accord with our previous observation that anti-NF155 was absent in 5 patients with both multiple sclerosis and chronic inflammatory demyelinating polyneuropathy. [2] In contrast, a high proportion (45-86%) of Japanese patients with CCPD had antibodies to NF155. [3,4] Differences in the assays are unlikely the cause for the discrepancy, as all four studies utilized cell-based assays with human NF155 transfected cells. The study by Cortese et al. is technically excellent, because it includes two ELISAs with different sources of NF155 in addition to a cell-based assay; [1] it confirms our previous observation that an ELISA with human NF155 derived from HEK cells is superior to rat NF155 from murine NSO cells to identify anti-NF155 positive patients. [5] As stated by Cortese et al., possible reasons for the different abundance of anti-NF155 in CCPD include differences in ethnicity (Caucasian vs Japanese) and also the heterogeneity of CCPD. [1-4] Thus, for many patients with CCPD, the relevant autoantigen, presumably shared between CNS and PNS (as is the case for NF155), remains to be identified.
1. Cortese A, Devaux JJ, Zardini E, et al. Neurofascin-155 as a putative antigen in combined central and peripheral demyelination. Neurol Neuroimmunol Neuroinflamm 2016;3:e238.
2. Vural A, Gocmen R, Kurne AT, et al. Fulminant Central Plus Peripheral Nervous System Demyelination without Antibodies to Neurofascin. Can J Neurol Sci 2016;43:149-156.
3. Kawamura N, Yamasaki R, Yonekawa T, et al. Anti-neurofascin antibody in patients with combined central and peripheral demyelination. Neurology 2013;81:714-722.
4. Ogata H, Matsuse D, Yamasaki R, et al. A nationwide survey of combined central and peripheral demyelination in Japan. J Neurol Neurosurg Psychiatry 2016;87:29-36.
5. Ng JK, Malotka J, Kawakami N, et al. Neurofascin as a target for autoantibodies in peripheral neuropathies. Neurology 2012;79:2241-2248.
For disclosures, please contact the editorial office at nnnjournal@neurology.org.
We read with interest the Clinical/Scientific Note by Cortese et al. reporting the absence of antibodies to neurofascin-155 (NF155) in 16 patients with combined central and peripheral demyelination (CCPD). [1] This report is in accord with our previous observation that anti-NF155 was absent in 5 patients with both multiple sclerosis and chronic inflammatory demyelinating polyneuropathy. [2] In contrast, a high proportion (45-86%) of Japanese patients with CCPD had antibodies to NF155. [3,4] Differences in the assays are unlikely the cause for the discrepancy, as all four studies utilized cell-based assays with human NF155 transfected cells. The study by Cortese et al. is technically excellent, because it includes two ELISAs with different sources of NF155 in addition to a cell-based assay; [1] it confirms our previous observation that an ELISA with human NF155 derived from HEK cells is superior to rat NF155 from murine NSO cells to identify anti-NF155 positive patients. [5] As stated by Cortese et al., possible reasons for the different abundance of anti-NF155 in CCPD include differences in ethnicity (Caucasian vs Japanese) and also the heterogeneity of CCPD. [1-4] Thus, for many patients with CCPD, the relevant autoantigen, presumably shared between CNS and PNS (as is the case for NF155), remains to be identified.
1. Cortese A, Devaux JJ, Zardini E, et al. Neurofascin-155 as a putative antigen in combined central and peripheral demyelination. Neurol Neuroimmunol Neuroinflamm 2016;3:e238.
2. Vural A, Gocmen R, Kurne AT, et al. Fulminant Central Plus Peripheral Nervous System Demyelination without Antibodies to Neurofascin. Can J Neurol Sci 2016;43:149-156.
3. Kawamura N, Yamasaki R, Yonekawa T, et al. Anti-neurofascin antibody in patients with combined central and peripheral demyelination. Neurology 2013;81:714-722.
4. Ogata H, Matsuse D, Yamasaki R, et al. A nationwide survey of combined central and peripheral demyelination in Japan. J Neurol Neurosurg Psychiatry 2016;87:29-36.
5. Ng JK, Malotka J, Kawakami N, et al. Neurofascin as a target for autoantibodies in peripheral neuropathies. Neurology 2012;79:2241-2248.
For disclosures, please contact the editorial office at nnnjournal@neurology.org.