Ganglionic acethylcholine receptor

Indication

Suspected autoimmune autonomic neuropathies.

Method

The 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).

Response

Results are given as negative or positive. Positive values are reported with a value.

Interpretation

Antibodies 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.

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References

Vernino 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

Acute test