Neurological deficits such as memory loss, behavioural abnormalities, movement disorders, seizures and psychosis can be caused by underlying autoimmune reactions. In many instances there is an association with malignant disease. In unexplained neurological cases, a thorough autoantibody analysis can help secure a diagnosis and, in some cases, may provide the first indication of a tumour. Autoantibodies in neurological diseases target a range of antigens, including intracellular proteins, receptors and ion channels. Since many of the autoantibodies are rare and clinical symptoms may overlap, comprehensive multiparameter testing is paramount.

Pioneering IFA range

Indirect immunofluorescence assays (IFA) are an indispensable method for the detection of neural autoantibodies. Tissue sections of nerves, cerebellum, hippocampus and intestine enable comprehensive screening of autoantibodies against both known and unknown target antigens.

For specific detection of defined autoantibodies, EUROIMMUN has developed IFA based on transfected human cells expressing the corresponding target antigen or epitopes thereof. This innovative technology is particularly suitable for neuronal cell-surface antigens, which are often conformation-dependent and fragile and thus unsuitable for the expression and purification procedures required for solidphase methods such as ELISA or immunoblot. Further, as the antigens do not need to be obtained in purified form, the assays can be developed rapidly, enabling novel parameters to be incorporated promptly into the test repertoire.

Cell-based assays with the CE mark are available for the detection of autoantibodies against NMDA receptors, AMPA 1/2 receptors. GABAB receptors, LGI1, CASPR2, DPPX, IgLon5, GAD65, Zic4, DNER/Tr, AQP- 4, MOG, AChR and MuSK. A large range of additional parameters is available for research use, including neurofascin 155, neurofascin 186, CASPR1, contactin-1, GABAA receptors, mGluR1, mGluR5, adenylate kinase 5 and flotillin-1/2.

Multiple antibodies can be easily investigated in parallel using BIOCHIP Mosaics composed of different tissue and cell substrates that are incubated simultaneously. EUROIMMUN offers a range of CE-marked IFA Mosaics tailored to different diagnostic applications; for example, autoimmune encephalitis, myasthenia gravis and neuromyelitis optica spectrum diseases (NMOSD).

Multiplex immunoblots Line blots

containing purified characterised antigens provide efficient monospecific detection of many different autoantibodies in parallel. The antigens on EUROLINE test strips are contained on individual membrane chips, allowing antigens with widely differing properties to be conveniently combined in application-oriented profiles.

The EUROLINE Paraneoplastic Neurologic Syndrome 12 Ag Profile includes the intracellular antigens amphiphysin, CV2, PNMA2 (Ma2/Ta), Ri, Yo, Hu, recoverin, SOX1, titin, Zic4, and GAD65 plus the receptor antigen DNER/Tr, enabling a broad analysis of autoantibodies associated with PNS. EUROLINE Ganglioside Profiles provide multiparameter detection of autoantibodies against gangliosides in polyneuropathies such as Guillain-Barré syndrome.

Automation solutions

EUROIMMUN offers a flexible range of automation solutions for neural autoantibody tests. These include instruments for processing IFA or immunoblots, automated microscopes, and advanced software for evaluation and documentation of results.