007 Immunotherapy responsive neuropathic pain associated with LGI1 and CASPR2 antibodies

Abstract

for patients diagnosed with psoriasis. The observed prevalence of psoriasis in MS patients was 12.19% however, the true prevalence is likely to be much higher as various symptoms of psoriasis were reported by a much larger proportion of MS patients. Of the 72 cases without psoriasis, various skin symptoms that were reported were intermittent irritation (for at least 6 months) or erythematous rash (35.4%), seasonal skin changes (39.0%) and thickened scaly skin behind ears and scalps (18.3%). Moreover, 18.3% had flaky, peeling or scaly skin while 24.4% experienced dandruff; 17.1% reported nail changes, and 13.4% reported a family history of psoriasis. The study also showed that combined psoriasis and eczema was relatively common at 3.7%. Conclusions In this pilot study there is a high prevalence of psoriasis in patients with MS suggesting an immunopathological association between the two diseases and indicates that further studies should be done to elucidate common mechanisms, and the nature of this phenotype.

A role for LGI1 in regulating pain sensitivity

“…Since nociceptor KO of LGI1 did not affect pain behaviours in the tSNI, our findings point to a spinal role of LGI1 in this context. Interestingly, in comparison to CASPR2-Ab patients, the distribution of pain in LGI1-Ab patients is more truncal suggestive of spinal involvement (Ramanathan et al, 2021). The exact mechanisms by which loss of spinal LGI1 enhances neuropathic pain remains to be investigated.…”

“…It can also regulate the intrinsic excitability of neurons in a Kv1 dependent manner (Seagar et al, 2017). LGI1 is the target of autoantibodies in neuropathic pain patients and pain can be relieved in these patients with therapies that either block or reduce the level of LGI1 antibodies (Gadoth et al, 2017;Ramanathan et al, 2021). These observations suggest that disruption of LGI1 is sufficient to cause neuropathic pain in patients and that LGI1 plays a role in regulating pain sensitivity.…”