Neurological Syndromes Associated with Anti-GAD Antibodies

Glutamic acid decarboxylase (GAD) is an intracellular enzyme whose physiologic function is the decarboxylation of glutamate to gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter within the central nervous system. GAD antibodies (Ab) have been associated with multiple neurological s...

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Detalles Bibliográficos
Autores: Dade, Maëlle, Berzero, Giulia, Izquierdo, Cristina, Giry, Marine, Benazra, Marion, Delattre, Jean-Yves, Psimaras, Dimitri, Alentorn, Agusti
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:252626
Acceso en línea:https://ddd.uab.cat/record/252626
https://dx.doi.org/urn:doi:10.3390/ijms21103701
Access Level:acceso abierto
Palabra clave:Glutamic acid decarboxylase
GAD65 autoimmunity
Neuronal antibodies
Paraneoplastic neurological syndromes
Limbic encephalitis
Autoimmune epilepsy
Cerebellar ataxia
Stiff-person syndrome
Descripción
Sumario:Glutamic acid decarboxylase (GAD) is an intracellular enzyme whose physiologic function is the decarboxylation of glutamate to gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter within the central nervous system. GAD antibodies (Ab) have been associated with multiple neurological syndromes, including stiff-person syndrome, cerebellar ataxia, and limbic encephalitis, which are all considered to result from reduced GABAergic transmission. The pathogenic role of GAD Ab is still debated, and some evidence suggests that GAD autoimmunity might primarily be cell-mediated. Diagnosis relies on the detection of high titers of GAD Ab in serum and/or in the detection of GAD Ab in the cerebrospinal fluid. Due to the relative rarity of these syndromes, treatment schemes and predictors of response are poorly defined, highlighting the unmet need for multicentric prospective trials in this population. Here, we reviewed the main clinical characteristics of neurological syndromes associated with GAD Ab, focusing on pathophysiologic mechanisms.