Neuronal antibody profile (Hu, Yo, Ri, CV2, Amphiphysin, Ma2/Ta) – paraneoplastic syndrome

General Information

Anti-neuronal antibodies represent a special category of autoantibodies associated with paraneoplastic neurological syndromes.

Paraneoplastic neurological syndromes accompany malignant tumors, but do not represent a condition caused by a primary or metastatic tumor, do not have a vascular or infectious origin. It also does not represent the results of side effects of medications. The basis of these syndromes are immunological mechanisms that develop away from the focus of the primary or metastatic tumor.

There are several types of antineuronal antibodies:

• anti-Hu IgG antibodies, anti-Ri IgG antibodies, and anti-Yo IgG antibodies (abbreviations derived from the names of the patients in whom these antibodies were first discovered
• ANNA antibodies – antineuronal antinuclear antibodies

Different types of tumor cells produce different types of antibodies. Cross-interaction of these antibodies with nerve cell-like antigens leads to the development of paraneoplastic syndrome.

• Anti-Hu IgG antibodies – associated with encephalomyelitis syndrome or sensory neuropathy. These antibodies are not found in healthy individuals, as well as in patients without paraneoplastic neurological syndrome. These antibodies are found in the neurological paraneoplastic syndrome associated with small cell lung cancer. A low titer of anti-Hu IgG antibodies indicates an early phase of the disease or a positive effect of chemotherapy.
• Anti-Ri IgG antibodies are the most commonly detected anti-neuronal antibodies. Determination of their titer in blood or cerebrospinal fluid is used to diagnose neurological disorders of unspecified origin (autoimmune, paraneoplastic). These antibodies are common in breast cancer. It is rarely found in other gynecological or lung cancers.
• Anti-Yo IgG antibodies are also known as anti-Purkinje cell antibodies because they damage the Purkinje cells of the corpus callosum. The research of the mentioned antibodies is conducted in patients with nystagmus, dysarthria and ataxia. Research of said antibodies is especially important in gynecological, lung and breast tumors.

The paraneoplastic syndrome is associated not only with malignant tumors, but also with diseases such as type 1 diabetes mellitus, in which the cross-reactivity of pancreatic islet autoantibodies to the gray matter of the brain is also observed.

Preparation of the patient: The study is performed on an empty stomach or after a meal

Material for examination: Venous blood

Reference norms

- Amphiphysin : negative

- CV2 : negative

-  Ma2/Ta : negative

- Ri : negative

-  Yo : negative

- Hu : negative

In the study of antineuronal antibodies, receiving positive results, it is necessary to look for a tumor causing a paraneoplastic neurological syndrome, even if there are no obvious signs of a tumor.

This is especially true for lung, breast and gynecological tumors.

Anti-Hu IgG antibodies may be positive even in the absence of malignancy in children with intestinal pathology, encephalitis, and ataxia.