HLA-dependency and possible clinical relevance of intrathecally synthesized anti-IgLON5 IgG4 in anti-IgLON5 disease
Anti-IgLON5 disease is a rare autoimmune disorder with IgLON5 autoantibodies predominantly of the IgG4 subclass. The clinical relevance of the pathogenic effects of anti-IgLON5 IgG1 and IgG4 is unclear. IgLON5-specific IgG1-4 levels were measured in 46 sera and 20 cerebrospinal fluid (CSF) samples from 13 HLA-subtyped anti-IgLON5 disease patients (6 female, 7 male) using flow cytometry. Intervals between two consecutive serum or CSF samplings were analyzed for treatment, changes of anti-IgLON5 IgG1/IgG4 levels and disease severity. Intrathecal anti-IgLON5 IgG4 synthesis (IS) was assessed. Th