Autoimmunity as a prognostic factor in sporadic adult onset cerebellar ataxia.

Autors de IIS La Fe

• Rafael Sivera Mascaró

  Autor

• 

  Teresa Sevilla Mantecón

  Autor

• Nuria Muelas Gómez

  Autor

• Inmaculada Azorín Villena

  Autor

• Juan Jesús Vílchez Padilla

  Autor

• Miguel Bolonio Garcia

  Autor

• Esther Donat Aliaga

  Autor

• 

  Carmen Ribes Koninckx

  Autor

• Luís Bataller Alberola

  Autor

Autors aliens a IIS La Fe

• Martín N
• Boscá I

Grups d'Investigació

• Enfermedad celíaca e Inmunopatología digestiva

  

  Leader

  Carmen Ribes Koninckx

• Patología Neuromuscular y Ataxias

  

  Investigador Principal

  Teresa Sevilla Mantecón

Abstract

Cerebellar adult onset ataxia is a heterogeneous condition. The aim of this study was to ascertain if there is a heightened autoimmune background in patients with sporadic cerebellar ataxia of unknown origin, and if autoimmunity correlates with a more rapid evolution of the ataxia. We selected patients with sporadic progressive adult onset cerebellar ataxia with a follow-up of >5 years. As controls we included 43 patients with genetically demonstrated hereditary ataxia. All patients were tested for a panel of neuronal (onconeuronal, glutamate-decarboxylase [GAD], IgG/IgA transglutaminase 6 antibodies) and systemic non-neuronal antibodies (including IgG/IgA gliadin and transglutaminase 2, thyroperoxidase, thyroglobulin, antinuclear, striational, smooth muscle, mitochondrial, liver kidney microsomal, and parietal gastric cells antibodies). Correlation between the antibodies and disease progression was studied with Cox regression models and Kaplan-Meier plots. Forty-four patients were included. All patients were negative for onconeuronal or GAD antibodies. There were no significant differences between patients and controls in the prevalence of transglutaminase 6, 2, gliadin, or thyroid antibodies. However, when we studied the panel of systemic non-neuronal autoantibodies as a group, antibodies were more frequent in patients with sporadic ataxia (p = 0.018). The presence of one or more systemic non-neuronal antibodies correlated with a faster evolution to stage 2 (loss of independent gait) (p = 0.03) and shorter survival (p = 0.03) in patients with sporadic ataxia. We conclude that there is probably a heightened autoimmune background in some patients with sporadic cerebellar ataxia of unknown origin. The presence of systemic non-neuronal autoantibodies is a prognostic marker.