INDIVIDUAL TEST 959

Ganglionic acetylcholine receptor

IndicationSuspected autoimmune autonomic neuropathies.MethodThe antigen are composed by alpha 3 subunit purified from mouse tumors. The antigen is bound to radiolabeled epibatidine and the analysis is carried out by radioimmunoprecipitation (RIA).ResponseResults are given as negative or positive. Positive values are reported with a value.InterpretationAntibodies against ganglionic acetylcholine receptors can be detected in approximately 50% of patients with autoimmune autonomic gangliopati (AAG). It is the alpha 3 subunit has been shown to be the major antigenic portion of ganglionic acethylcholin receptor. The symptoms are sometimes referred to as acute autonomic neuropathy or acute cholinergic neuropathy and idiopathic and paraneoplastic autonomic neuropathy. Antibody titers correlates with the severity of symptoms and a decrease in antibody levels during treatment improves autonomic symptoms.
Generally, treatment with immunotherapy are often more effective at auto-antibodies directed against extracellular antigens than auto-antibodies against intracellular antigens.

ReferencesVernino S, Low PA, Fealey RD, Stewart JD, Farrugia G, Lennon VA. Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies. N Engl J Med. 2000 Sep 21;343(12):847-55.PMID: 10995864

Koike H, Watanabe H, Sobue G. The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features. J Neurol Neurosurg Psychiatry. 2013 Jan;84(1):98-106. PMID: 22906617

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Neurology

ENSKILD ANALYS 959

Ganglionära AChR-antikroppar

IndikationMisstanke om autoimmuna autonomiska neuropatier.MetodRadioimmunoprecipitation (RIA).SvarResultatet anges som antikropps enhet.TolkningAntikroppar mot ganglionär acetylcholinreceptor (ganglionär AChR) kan detekteras hos ca 50% av patienter med autoimmun autonomic gangliopati (AAG). Det är alfa-3-subenheten som har visat sig vara den viktigaste antigen delen av ganglionär acethylcholin receptor. Symptomen benämns ibland som akut autonomisk neuropati eller akut cholinergic neuropati och idiopatisk och paraneoplastisk autonomic neuropati. Antikropps titrarna korrelerar till graden av symptom och en minskning av antikroppsnivåerna vid behandling förbättrar den autonoma symptomen.

Generellt sett är behandling med immunoterapi oftare effektfull vid auto-antikroppar riktade mot extracellulära antigen än vid auto-antikroppar mot intracellulära antigen.



ReferensVernino S, Low PA, Fealey RD, Stewart JD, Farrugia G, Lennon VA. Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies. N Engl J Med. 2000 Sep 21;343(12):847-55.PMID: 10995864

Koike H, Watanabe H, Sobue G. The spectrum of immune-mediated autonomic neuropathies: insights from the clinicopathological features. J Neurol Neurosurg Psychiatry. 2013 Jan;84(1):98-106. PMID: 22906617

 

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