Autoantibodies against the amino terminal of α-enolase are a useful diagnostic marker of Hashimoto's encephalopathy

Fujii, Akihiro; Yoneda, Makoto; Ito, Takahiro; Yamamura, Osamu; Satomi, Satoko; Higa, Harry H.; Kimura, Akio; Suzuki, Masahide; Yamashita, M; Yuasa, Tatsuhiko; Suzuki, Hidekazu; Kuriyama, Masaru

doi:10.1016/j.jneuroim.2005.02.004

Cited by 150 publications

(117 citation statements)

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“…Antibodies against human enolase protein have been detected in certain autoimmune disorders such as Hashimoto's encephalopathy (16,33), retinopathy (26,60), rheumatoid arthritis (21,46), systemic sclerosis (29), autoimmune premature ovarian failure (51), relapsing polychondritis (52), and lung adenocarcinoma (54). Detection of anti-enolase antibodies has been suggested as a means of specific diagnosis for some of these disorders (16,51,54,60).…”

Section: Discussionmentioning

confidence: 99%

“…Detection of anti-enolase antibodies has been suggested as a means of specific diagnosis for some of these disorders (16,51,54,60). Although the pathological significance of these anti-enolase antibodies is not very clear, one has to exercise caution in the advocacy of Pfen as a malaria vaccine candidate and use only those regions of the protein that are protective and also very specific for the parasite.…”

Section: Discussionmentioning

confidence: 99%

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Protective Properties and Surface Localization ofPlasmodium falciparumEnolase

et al. 2007

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The enolase protein of the human malarial parasite Plasmodium falciparum has recently been characterized. Apart from its glycolytic function, enolase has also been shown to possess antigenic properties and to be present on the cell wall of certain invasive organisms, such as Candida albicans. In order to assess whether enolase of P. falciparum is also antigenic, sera from residents of a region of Eastern India where malaria is endemic were tested against the recombinant P. falciparum enolase (r-Pfen) protein. About 96% of immune adult sera samples reacted with r-Pfen over and above the seronegative controls. Rabbit anti-r-Pfen antibodies inhibited the growth of in vitro cultures of P. falciparum. Mice immunized with r-Pfen showed protection against a challenge with the 17XL lethal strain of the mouse malarial parasite Plasmodium yoelii. The antibodies raised against r-Pfen were specific for Plasmodium and did not react to the host tissues. Immunofluorescence as well as electron microscopic examinations revealed localization of the enolase protein on the merozoite cell surface. These observations establish malaria enolase to be a potential protective antigen.Malaria continues to be a life-threatening infectious disease in the tropical world. Despite tremendous efforts to control the malaria epidemic, current prophylaxis and drug treatments are proving insufficient. The extensive spreading of drug-resistant Plasmodium strains as well as insecticide-resistant mosquitoes makes it urgent to develop an effective malaria vaccine. Long years of antigen identification and characterization have yielded many potential vaccine candidates, but developing an effective malaria vaccine has remained an incredibly difficult challenge (17). It has been observed that immunity to the disease develops gradually, after many attacks and over many years, in adults living in areas where malaria is endemic (2). The successful passive transfer of this immunity by injecting antibodies from malaria-immune persons to children susceptible to malaria has demonstrated that antibodies alone can trigger protection (5, 9, 58). These experiments have worked across geographical borders, as immunoglobulin G (IgG) from malaria-immune West Africans have cured East Africans as well as Thai malaria patients (5). The nature of this immunity is poorly understood at the molecular level. However, attempts have been made to identify antigens, the humoral response against which leads to protection. Seroepidemiological studies have identified several specific malarial blood-stage antigens including ring-infected erythrocyte surface antigen (10), apical membrane antigen (53), and PfP0, a conserved ribosomal protein (7,18,24), as protective antigens.Enolase has been reported to be present on the cell surface of several organisms (38). It is also considered to be a major immunostimulatory protein in the case of visceral leishmaniasis (19). Enolase has been demonstrated to play a protective role in Candida albicans infection (31, 41, 55). Recently, it has also been ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Protective Properties and Surface Localization ofPlasmodium falciparumEnolase

et al. 2007

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“…However, it was reported in previous studies that HE might develop an autoimmune cerebral vasculitis picture due to endothelial inflammation damage or immune complex accumulation (3,12). In studies about autoimmunity, it was reported that an antibody which was directed to amino terminal of alpha enolase enzyme, which took place in glycolysis reactions, might be a bio-marker for this disorder (12,13). In a study conducted on Hashimoto thyroiditis patients with HE, without HE, and health control groups, and it was reported that antibody against alpha enolase was markedly higher in the patients with HE (13).…”

Section: Discussionmentioning

confidence: 99%

“…In studies about autoimmunity, it was reported that an antibody which was directed to amino terminal of alpha enolase enzyme, which took place in glycolysis reactions, might be a bio-marker for this disorder (12,13). In a study conducted on Hashimoto thyroiditis patients with HE, without HE, and health control groups, and it was reported that antibody against alpha enolase was markedly higher in the patients with HE (13). Presence of alpha enolase antigen on endothelial cells in addition to brain and thyroid tissues supports the idea that autoimmune vasculitis is related to HE pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

A case of steroid-responsive encephalopathy associated with autoimmune thyroiditis (Hashimoto’s encephalopathy)

Tatlı¹

2016

Dusunen Adam

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A case of steroid-responsive encephalopathy associated with autoimmune thyroiditis (Hashimoto's encephalopathy)Hashimoto's encephalopathy (HE) is a syndrome which represents itself with diverse neuropsychiatric symptoms and high titers of antithyroid antibodies, the syndrome has no specific radiological or EEG findings, and it can be dramatically resolved with corticosteroid treatment. HE can show different clinical findings such as, confusion, stupor, coma, stroke like episodes, epileptic seizures, myoclonus, behavioral changes, hallucinations and delusions. The cause of HE has been proposed to be autoimmune because of it's association with other immunologic disorders, female predominance, inflammatory findings in cerebrospinal fluid and response to treatment with streoids. Because the disease has a wide range of symptom scala and has no specific radiological findings and also has no proven pathogenetic mechanism that can explain the occurence of the disease it is thought that the diagnosis of the syndrome can be delayed or the disease can be misdiagnosed. This knowledge is thought to be crucial as we know that corticosteroid treatment can lead to quick and dramatic response when the syndrome is diagnosed early.In this case report, a patient who applied to our clinic with findings of cognitive and psychotic disturbances and was followed up with the HE diognosis is presented.Keywords: Hashimoto's encephalitis, psychosis, thyroiditis ÖZET Steroide yanıt veren otoimmün tiroiditle ilgili ensefalopati olgusu (Hashimoto ensefalopatisi)Hashimoto enfesalopatisi (HE); nöropsikiyatrik semptomlar ve yüksek antitiroid antikor seviyeleri ile karakterize olan, kendine özgü radyolojik ya da EEG bulguları olmayan ve steroid tedavisiyle hızlı bir klinik düzelme gözlenen bir bozukluktur. HE; konfüzyon, stupor, koma, inme benzeri tablolar, titreme, epileptik nöbetler, miyoklonus, davranış değişiklikleri, varsanı ve hezeyan gibi pek çok farklı klinik görünümlerle ortaya çıkabilmektedir. Hastalığın kadınlarda daha sık görülmesi, beyin omurilik sıvısında enflamasyon bulgularına rastlanabilmesi, steroid tedavisine iyi yanıt vermesi ve diğer otoimmüne hastalıklarla birlikte görülebilmesi otoimmünitenin bu bozukluğun gelişiminde üzerinde önemle durulması gereken bir olgu olduğunu düşündürmektedir. HE'nin geniş bir yelpazeyi içeren klinik görünümlerle kendini gösterebilmesi, spesifik görüntüleme bulgularının olmaması, patogenezinin henüz tam olarak anlaşılamamasından dolayı bu sendroma ilişkin tanı koymada gecikilebileceği hatta bazı olgularda bu tanının atlanabileceği, erken tanı konulması halinde ise steroid tedavisiyle hızlı ve dramatik bir iyileşme gözlenebileceği düşünülmektedir. Bu vaka sunumunda kliniğimize kognitif bozukluk ve psikotik bulgularla başvuran ve HE tanısıyla takip edilen bir olgu bildirilmektedir.

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“…Postmortem examination demonstrated mild perivascular lymphocytic infiltration throughout the brain and leptomeninges plus diffuse gliosis of gray matter in the cortex and basal ganglia, and to a lesser extent, the parenchymal white matter (25). Recently, Fujii et al (27) …”

Section: F I G U R E 5 P E R I V a S C U L A R L Y Mp H O C Y T I Cmentioning

confidence: 99%

Neuropathological Studies of Patients with Possible Non-Herpetic Acute Limbic Encephalitis and So-called Acute Juvenile Female Non-Herpetic Encephalitis

et al. 2008

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Autoantibodies against the amino terminal of α-enolase are a useful diagnostic marker of Hashimoto's encephalopathy

Cited by 150 publications

References 22 publications

Protective Properties and Surface Localization ofPlasmodium falciparumEnolase

Protective Properties and Surface Localization ofPlasmodium falciparumEnolase

A case of steroid-responsive encephalopathy associated with autoimmune thyroiditis (Hashimoto’s encephalopathy)

Neuropathological Studies of Patients with Possible Non-Herpetic Acute Limbic Encephalitis and So-called Acute Juvenile Female Non-Herpetic Encephalitis

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