TY  - JOUR
A1  - Simon, Christian M.
A1  - Rauskolb, Stefanie
A1  - Gunnersen, Jennifer M.
A1  - Holtmann, Bettina
A1  - Drepper, Carsten
A1  - Dombert, Benjamin
A1  - Braga, Massimiliano
A1  - Wiese, Stefan
A1  - Jablonka, Sibylle
A1  - Pühringer, Dirk
A1  - Zielasek, Jürgen
A1  - Hoeflich, Andreas
A1  - Silani, Vincenzo
A1  - Wolf, Eckhard
A1  - Kneitz, Susanne
A1  - Sommer, Claudia
A1  - Toyka, Klaus V.
A1  - Sendtner, Michael
T1  - Dysregulated IGFBP5 expression causes axon degeneration and motoneuron loss in diabetic neuropathy
JF  - Acta Neuropathologica
N2  - Diabetic neuropathy (DNP), afflicting sensory and motor nerve fibers, is a major complication in diabetes.The underlying cellular mechanisms of axon degeneration are poorly understood. IGFBP5, an inhibitory binding protein for insulin-like growth factor 1 (IGF1) is highly up-regulated in nerve biopsies of patients with DNP. We investigated the pathogenic relevance of this finding in transgenic mice overexpressing IGFBP5 in motor axons and sensory nerve fibers. These mice develop motor axonopathy and sensory deficits similar to those seen in DNP. Motor axon degeneration was also observed in mice in which the IGF1 receptor(IGF1R) was conditionally depleted in motoneurons, indicating that reduced activity of IGF1 on IGF1R in motoneurons is responsible for the observed effect. These data provide evidence that elevated expression of IGFBP5 in diabetic nerves reduces the availability of IGF1 for IGF1R on motor axons, thus leading to progressive neurodegeneration. Inhibition of IGFBP5 could thus offer novel treatment strategies for DNP.
KW  - Motor nerve biopsy
KW  - Diabetic polyneuropathy
KW  - Neuropathy
KW  - Neurotrophic factors
KW  - Axonal degeneration
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-154569
VL  - 130
SP  - 373
EP  - 387
ER  - 
TY  - JOUR
A1  - Doppler, Kathrin
A1  - Schuster, Yasmin
A1  - Appeltshauser, Luise
A1  - Biko, Lydia
A1  - Villmann, Carmen
A1  - Weishaupt, Andreas
A1  - Werner, Christian
A1  - Sommer, Claudia
T1  - Anti-CNTN1 IgG3 induces acute conduction block and motor deficits in a passive transfer rat model
JF  - Journal of Neuroinflammation
N2  - Background:
Autoantibodies against the paranodal protein contactin-1 have recently been described in patients with severe acute-onset autoimmune neuropathies and mainly belong to the IgG4 subclass that does not activate complement. IgG3 anti-contactin-1 autoantibodies are rare, but have been detected during the acute onset of disease in some cases. There is evidence that anti-contactin-1 prevents adhesive interaction, and chronic exposure to anti-contactin-1 IgG4 leads to structural changes at the nodes accompanied by neuropathic symptoms. However, the pathomechanism of acute onset of disease and the pathogenic role of IgG3 anti-contactin-1 is largely unknown.

Methods:
In the present study, we aimed to model acute autoantibody exposure by intraneural injection of IgG of patients with anti-contacin-1 autoantibodies to Lewis rats. Patient IgG obtained during acute onset of disease (IgG3 predominant) and IgG from the chronic phase of disease (IgG4 predominant) were studied in comparison.

Results:
Conduction blocks were measured in rats injected with the “acute” IgG more often than after injection of “chronic” IgG (83.3% versus 35%) and proved to be reversible within a week after injection. Impaired nerve conduction was accompanied by motor deficits in rats after injection of the “acute” IgG but only minor structural changes of the nodes. Paranodal complement deposition was detected after injection of the “acute IgG”. We did not detect any inflammatory infiltrates, arguing against an inflammatory cascade as cause of damage to the nerve. We also did not observe dispersion of paranodal proteins or sodium channels to the juxtaparanodes as seen in patients after chronic exposure to anti-contactin-1.

Conclusions:
Our data suggest that anti-contactin-1 IgG3 induces an acute conduction block that is most probably mediated by autoantibody binding and subsequent complement deposition and may account for acute onset of disease in these patients. This supports the notion of anti-contactin-1-associated neuropathy as a paranodopathy with the nodes of Ranvier as the site of pathogenesis.
KW  - complement deposition
KW  - paranodopathy
KW  - anti-contactin-1
KW  - CIDP
KW  - passive transfer
KW  - autoantibody
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200476
VL  - 16
IS  - 73
ER  -