Chapter 39 : Detection of Anticytokine Autoantibodies and Clinical Applications

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Anticytokine autoantibodies are an emerging mechanism of disease pathogenesis that have been shown to elicit a broad range of clinical phenotypes. Some anticytokine autoantibodies can lead to immune susceptibility, with examples including nontuberculous mycobacteria, salmonellae, or fungi due to autoantibodies against gamma interferon (IFN-γ) (1); staphylococcal infection due to anti-interleukin-6 (IL-6) autoantibodies (2); infection due to anti-IL-12p70 autoantibodies (3); chronic mucocutaneous candidiasis due to anti-IL-17 and anti-IL-22 autoantibodies (4, 5); and cryptococcal meningitis (6) or infection due to anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies (7). Other diseases in which immunodeficiency is not the primary presentation include the severe lung disease pulmonary alveolar proteinosis (PAP) caused by anti-GM-CSF autoantibodies; pure red cell aplasia (8); pure red-cell aplasia due to antierythropoietin autoantibodies (9); and severe osteoporosis associated with antiosteoprotegerin autoantibodies (10). For other anticytokine autoantibodies, such as anti-IFN-α autoantibodies detected in thymoma or autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome, their biological effect is not immediately apparent (11). Diagnosis has important implications for management because therapies can be used to directly target the underlying mechanism, i.e., a neutralizing antibody, and not just their ultimate clinical consequences, with approaches such as B-cell depletion (12–14) or receptor agonists (15).

Citation: Browne S. 2016. Detection of Anticytokine Autoantibodies and Clinical Applications, p 365-372. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch39
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Summary of anticytokine autoantibody detection assays. LIPS, luciferase immunoprecipitation system; PE, phycoerythrin; RIA, radioimmunoassay.

Citation: Browne S. 2016. Detection of Anticytokine Autoantibodies and Clinical Applications, p 365-372. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch39
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Anticytokine autoantibody-associated syndromes

Citation: Browne S. 2016. Detection of Anticytokine Autoantibodies and Clinical Applications, p 365-372. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch39

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