Humoral and cellular immune parameters before and during immunosuppressive therapy of a patient with stiff-man syndrome and insulin dependent diabetes mellitus

M. Hummel, I. Durinovic-Bello, E. Bonifacio, V. Lampasona, J. Endl, S. Fessele, F. Then Bergh, C. Trenkwalder, E. Standl, A. G. Ziegler

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives - Humoral and cellular immune reactivity are reported for two neuroendocrine autoantigens - glutamic acid decarboxylase (GAD) and the protein tyrosine phosphatase IA-2 - in a patient with the autoimmune type of stiff-man syndrome and insulin dependent diabetes (IDDM). Methods - Antibodies and T cell proliferation against GAD and IA-2 and cytokine release of antigen stimulated T cells (IFN-γ) were determined before and several times during immunosuppressive therapy with prednisolone. Results - Raised GAD antibodies against full length GAD65 or chimeric constructs were detected before therapy and they remained at a high concentration despite a marked clinical improvement during cortisone treatment. Antibodies to IA-2 were undetectable, but weak T cell responses to both GAD and IA-2 were seen before therapy and once on reduction of high cortisone dosages when the patient showed signs of clinical deterioration. Cytokine profiles showed increased IFN-γ production after stimulation with GAD or IA-2 suggesting increased activation of T(H)1 cells. Conclusion - Immunosuppressive therapy - even with extremely high doses of 500 mg a day - does not lead to the reduction of antibody concentrations in the periphery nor to a switch in epitope recognition of such antibodies despite clinical improvement. The amount of T cell reactivity to various antigens, however, may be a useful marker to monitor the effectiveness of immunotherapy.

Original languageEnglish
Pages (from-to)204-208
Number of pages5
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume65
Issue number2
Publication statusPublished - Aug 1998

Keywords

  • Autoantibodies
  • Prednisolone therapy
  • Stiff-man syndrome
  • T cell reactivity

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Psychiatry and Mental health

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