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Open Access Research

Immune response profiling identifies autoantibodies specific to Moyamoya patients

Tara K Sigdel14, Lorelei D Shoemaker236, Rong Chen4, Li Li4, Atul J Butte4, Minnie M Sarwal145* and Gary K Steinberg236*

Author Affiliations

1 California Pacific Medical Center Research Institute, San Francisco, CA, 94107, USA

2 Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, 94305, USA

3 Stanford Institute for Neuro-Innovation & Translational Neurosciences, Stanford University, Stanford, CA, 94305, USA

4 Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA

5 Pediatrics and Transplant Nephrology, California Pacific Medical Center Research Institute, 475 Brannan Street, San Francisco, CA, 94107, USA

6 Stanford Stroke Center, 300 Pasteur Drive, R281, Stanford, CA, 94305-5327, USA

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Orphanet Journal of Rare Diseases 2013, 8:45  doi:10.1186/1750-1172-8-45

Published: 21 March 2013

Abstract

Background

Moyamoya Disease is a rare, devastating cerebrovascular disorder characterized by stenosis/occlusion of supraclinoid internal carotid arteries and development of fragile collateral vessels. Moyamoya Disease is typically diagnosed by angiography after clinical presentation of cerebral hemorrhage or ischemia. Despite unclear etiology, previous reports suggest there may be an immunological component.

Methods

To explore the role of autoimmunity in moyamoya disease, we used high-density protein arrays to profile IgG autoantibodies from the sera of angiographically-diagnosed Moyamoya Disease patients and compared these to healthy controls. Protein array data analysis followed by bioinformatics analysis yielded a number of auto-antibodies which were further validated by ELISA for an independent group of MMD patients (nā€‰=ā€‰59) and control patients with other cerebrovascular diseases including carotid occlusion, carotid stenosis and arteriovenous malformation.

Results

We identified 165 significantly (pā€‰<ā€‰0.05) elevated autoantibodies in Moyamoya Disease, including those against CAMK2A, CD79A and EFNA3. Pathway analysis associated these autoantibodies with post-translational modification, neurological disease, inflammatory response, and DNA damage repair and maintenance. Using the novel functional interpolating single-nucleotide polymorphisms bioinformatics approach, we identified 6 Moyamoya Disease-associated autoantibodies against APP, GPS1, STRA13, CTNNB1, ROR1 and EDIL3. The expression of these 6 autoantibodies was validated by custom-designed reverse ELISAs for an independent group of Moyamoya Disease patients compared to patients with other cerebrovascular diseases.

Conclusions

We report the first high-throughput analysis of autoantibodies in Moyamoya Disease, the results of which may provide valuable insight into the immune-related pathology of Moyamoya Disease and may potentially advance diagnostic clinical tools.

Keywords:
Autoantibodies; Cerebrovascular disease; Moyamoya; Protein microarray