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Seronegative antibody-mediated neurology after immune checkpoint inhibitors

Seronegative antibody-mediated neurology after immune checkpoint inhibitors
Seronegative antibody-mediated neurology after immune checkpoint inhibitors
Checkpoint-inhibitor medications have revolutionized oncology practice, but frequently induce immune-related adverse events. During autoimmune neurology practice over 20-months, we prospectively identified four patients with likely antibody-mediated neurological diseases after checkpoint-inhibitors: longitudinally extensive transverse myelitis, Guillain-Barré syndrome and myasthenia gravis. All patients shared three characteristics: symptoms commenced four-weeks after drug administration, responses to conventional immunotherapies were excellent and autoantibodies traditionally associated with their syndrome were absent. Indeed, serum immunoglobulins from the myelitis and Guillain-Barré syndrome patients showed novel patterns of tissue reactivity. Vigilance is required for antibody-mediated neurology after checkpoint-inhibitor administration. This phenomenon may inform the immunobiology of antibody-mediated diseases.
1-6
Wilson, Robert
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Menassa, David A.
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Davies, Alexander J
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Michael, Sophia
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Hester, Joanna
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Kuker, Wilhelm
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Collins, Graham P
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Cossins, Judith
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Beeson, David
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Steven, Neil
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Maddison, Paul
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Rinaldi, Simon
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Jacob, Saiju
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Irani, Sarosh R
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Wilson, Robert
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Menassa, David A.
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Davies, Alexander J
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Michael, Sophia
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Hester, Joanna
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Kuker, Wilhelm
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Collins, Graham P
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Cossins, Judith
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Beeson, David
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Steven, Neil
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Maddison, Paul
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Rinaldi, Simon
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Jacob, Saiju
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Irani, Sarosh R
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Wilson, Robert, Menassa, David A., Davies, Alexander J, Michael, Sophia, Hester, Joanna, Kuker, Wilhelm, Collins, Graham P, Cossins, Judith, Beeson, David, Steven, Neil, Maddison, Paul, Rinaldi, Simon, Jacob, Saiju and Irani, Sarosh R (2018) Seronegative antibody-mediated neurology after immune checkpoint inhibitors. Annals of Clinical and Translational Neurology, 1-6. (doi:10.1002/acn3.547).

Record type: Article

Abstract

Checkpoint-inhibitor medications have revolutionized oncology practice, but frequently induce immune-related adverse events. During autoimmune neurology practice over 20-months, we prospectively identified four patients with likely antibody-mediated neurological diseases after checkpoint-inhibitors: longitudinally extensive transverse myelitis, Guillain-Barré syndrome and myasthenia gravis. All patients shared three characteristics: symptoms commenced four-weeks after drug administration, responses to conventional immunotherapies were excellent and autoantibodies traditionally associated with their syndrome were absent. Indeed, serum immunoglobulins from the myelitis and Guillain-Barré syndrome patients showed novel patterns of tissue reactivity. Vigilance is required for antibody-mediated neurology after checkpoint-inhibitor administration. This phenomenon may inform the immunobiology of antibody-mediated diseases.

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Accepted/In Press date: 12 February 2018
e-pub ahead of print date: 25 March 2018

Identifiers

Local EPrints ID: 418140
URI: http://eprints.soton.ac.uk/id/eprint/418140
PURE UUID: 6ac7340d-afc8-4dcf-809b-c57af2a51c68

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Date deposited: 22 Feb 2018 17:30
Last modified: 16 Mar 2024 06:13

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Contributors

Author: Robert Wilson
Author: David A. Menassa
Author: Alexander J Davies
Author: Sophia Michael
Author: Joanna Hester
Author: Wilhelm Kuker
Author: Graham P Collins
Author: Judith Cossins
Author: David Beeson
Author: Neil Steven
Author: Paul Maddison
Author: Simon Rinaldi
Author: Saiju Jacob
Author: Sarosh R Irani

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