Neurofascin-155 IgG and IgM antibodies (NF155)

Indication

Rapidly progressive Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) that is refractory to standard treatment.

Method

Western Blot. 

Answer

The result is given as negative or positive for IgG and/or IgM antibodies.

Interpretation

Neurofascin-155 (NF155) is a paranodal protein of importance for the function of the node of Ranvier. IgG autoantibodies against NF155 have been identified in 5-10% of patients with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). This subgroup is characterized by younger age at onset (20-30 years), subacute and rapidly progressing course with ataxia, tremor, distal weakness and a poor response to treatment with intravenous immunoglobulin (IVIg) or steroids but may respond to plasmapheresis or rituximab (Querol L et al., 2015). Combination of central demyelination has been reported.

IgG antibodies are dominated by IgG4 subclass (Vural A et al., 2018). See test Neurofascin-155 antibodies - IgG4 subclass determination.

IgM autoantibodies against NF155 may occur in the absence of IgG antibodies in patients with inflammatory neuropathy. Testing of IgM autoantibodies is therefore of interest although their pathogenic role is not yet fully understood (Doppler et al., 2018).

References

Vallat J-M et al., Neuromuscular Disorders 2016 (PMID 27986399)
Kadoya M et al., Journal of Neuroimmunology 2016 (PMID 27852440)
Querol L et al., Neurology 2014 (PMID 24523485)
Querol L et al., Neurol. Neuroimmunol. Neuroinflamm. 2015 (PMID 26401517)
Delmont E et al., Brain 2017: 140; 1851–1858
Vural A et al., Front. Immunol., 14 May 2018

Read more about sampling

Packages and other tests

View other packages CIDP - Chronic Inflammatory Demyelinating Polyneuropathy (537), Inflammatory neuropathy (Guillain-Barré) (534). View other tests Contactin-1 IgG antibodies (CNTN1), Contactin-1 IgG antibodies (CNTN1) – IgG4 subclass determination, Neurofascin-155 (NF155) antibodies - IgG4 subclass determination

Own immunologist