AMPA receptor 1 and 2 (GluR1 and GluR2) antibodies

Indication

Suspicion of paraneoplastic syndromes particularly in autoimmune encephalitis.

Method

Indirect immunofluorescence (IIF) using transfected cells.

Answer

The result is reported as positive or negative. A positive result is followed by a titer (serum).

Interpretation

Antibodies against AMPA 1/2 receptors can be seen in paraneoplastic syndrome and in classical autoimmune encephalitis, but cases of isolated psychoses have also been described. There are relatively few cases published, of which 90% have been women. Age at diagnosis has been 38-87 years (median 60 years). The antibodies have been associated with tumors (lung, breast and thymoma) in 70% of the cases. Antibodies may occur together with other autoantibodies in around 60% of the cases (antibodies against ANA, GAD-65, cardiolipin, VGCC, SOX1, CV2/CRMP5 and TPO).

The AMPA receptors belong to the group of extracellular antigens. Generally, immunotherapy is more often effective in autoantibodies directed against extracellular antigens than in autoantibodies against intracellular antigens. Antibody titers can be used to monitor treatment effectiveness. Screening for cancer diagnosis is recommended.

References

Lancaster, Martinez-Hernandez, Dalmau. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011 Jul 12;77(2):179-89.  PMID: 21747075.

Titulaera et al. Screening for tumours in paraneoplastic syndromes: report of an EFNS Task Force. European Journal of Neurology. Epublished 2010. Eur J Neurol. 2011 January; 18(1): 19–23. PMID: 20880069.

Zuliani, Graus, Giometto, Bien, Vincent. Central nervous system neuronal surface antibody associated syndromes: review and guidelines for recognition. J Neurol Neurosurg Psychiatry 2012;83:638-645. PMID: 22448032.

Lai, Hughes, Peng, et al. AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol 2009;65:424-434. PMID 19338055.

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Packages and other tests

View other packages Paraneoplastic Syndromes and Limbic Encephalitis (560, 561 and 562). View other tests CASPR2 antibodies, GABA B receptor antibodies, LGI-1 antibodies, NMDA receptor antibodies, VGCC (voltage-gated calcium channel) antibodies, VGKC (voltage gated potassium channel) antibodies

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