Selective expression of Purkinje-cell antigens in tumor tissue from patients with paraneoplastic cerebellar degeneration

Article Abstract:

Patients with cancer sometimes show symptoms of a rare disorder of the cerebellum called paraneoplastic cerebellar degeneration. (The cerebellum is the part of the brain that controls many kinds of muscle movement.) Symptoms of paraneoplastic cerebellar degeneration develop rapidly and include difficulty in speaking, nystagmus (involuntary, rhythmic movements of the eye), and poor muscle coordination. The disorder is also characterized by the depletion of Purkinje cells, a type of neuron (brain cell) in the cerebellum. Neurological changes may precede cancer detection by many months, or even years. It has been shown that patients with gynecologic tumors and paraneoplastic cerebellar degeneration have high levels of an autoantibody (an antibody against proteins present in one's own body) called anti-Purkinje cell or anti-Yo antibody, which reacts with an antigen component of the Purkinje cells. To determine whether the tumor cells of patients with paraneoplastic degeneration contain Purkinje-cell antigens, tumor tissue was evaluated from 10 patients with paraneoplastic cerebellar degeneration and anti-Yo antibodies, and 11 patients with ovarian cancer and 10 breast cancer patients who were neurologically normal. The results revealed that Purkinje-cell antigens were present in the tumors of all the patients with paraneoplastic cerebellar degeneration staining; none of the tumors from the other 21 patients was positive for these antigens. Detecting anti-Yo antibody was crucial to treatment for three of these patients, whose cancer had not been previously detected. In the case of one patient, the cancer was microscopic and located in the fallopian tube, undetectable until all the female reproductive organs were removed and biopsied. Possible interpretations of these results are discussed. The preferred hypothesis is that an autoimmune response is directed against a tumor antigen, which also appears on Purkinje cells; the anti-Yo antibodies may destroy the cerebellum's Purkinje cells. These findings can help illuminate the relationship between cancer and the immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Identification and classification, Cancer, Autoimmunity, Tumors, Purkinje cells

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A serologic marker of paraneoplastic limbic and brain-stem encephalitis in patients with testicular cancer

Article Abstract:

There appears to be a protein in the limbic part of the brain that also occurs in testicular cancer. The limbic area of the brain includes the hippocampus, amygdala, and hypothalamus. One complication of many cancers is a condition called paraneoplastic syndrome. Often this syndrome can affect the limbic area of the brain. In a study of 13 patients with testicular cancer and a limbic paraneoplastic syndrome, 10 had antibodies to a protein that occurred in the testicular tumor and the brain. This indicates that antibodies against the tumor probably cause the paraneoplastic syndrome.

Testicular cancer

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Paraneoplastic syndromes involving the nervous system

Article Abstract:

The physiology and treatment of nervous system disorders in patients who have cancer are reviewed. Most if not all of these nervous system disorders are caused by antibodies, probably antibodies produced to fight the cancer. Sometimes the cancer has not been discovered yet, and it is the symptoms of the nervous system disorder that make the patient see a doctor.

Care and treatment, Nervous system diseases

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