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Glantschnigg-Eisl U, Klang A, Kneissl S, Lang B, Waters P, Irani SR, Binks SNM, Pakozdy A. A feline model of spontaneously occurring autoimmune limbic encephalitis. Vet J 2023; 296-297:105974. [PMID: 36958405 DOI: 10.1016/j.tvjl.2023.105974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
Autoimmune encephalitis (AE) is an important cause of encephalitis in humans and occurs at a similar rate to infectious encephalitis. It is frequently associated with antibodies against the extracellular domain of neuronal proteins. Among human AE, that with antibodies against leucine-rich glioma-inactivated 1 (LGI1) is one of the most prevalent forms, and was recently described in cats with limbic encephalitis (LE). In this study, we describe a large cohort (n = 32) of cats with AE, tested positive for voltage gated potassium channel (VGKC)-antibodies, of which 26 (81%) harboured LGI1-antibodies. We delineate their clinical and paraclinical features as well as long-term outcomes up to 5 years. Similar to human cases, most cats with LGI1-antibodies had a history of focal seizures (83%), clustering in the majority (88%), with interictal behavioural changes (73%). Among feline AE patients, there was no seizure type or other clinical characteristic that could distinguish LGI1-antibody positive from negative cats, unlike the pathognomic faciobrachial dystonic seizures seen in humans. Although six cats were euthanased in the first year for epilepsy-associated reasons, those attaining at least 1-year survival had good seizure control and quality of life with appropriate veterinary care and medication. Acute-phase immunotherapy (prednisolone) was given to the most severely unwell cases and its effect is retrospectively evaluated in 10 cats. Our data show LGI1-antibodies are an important cause of feline encephalitis, sharing many features with human AE. Further research should examine optimal therapeutic management strategies and the cause of LE in seronegative cats, building on paradigms established in the counterpart human disease.
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Affiliation(s)
- U Glantschnigg-Eisl
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria.
| | - A Klang
- Institute for Pathology and Forensic Veterinary Medicine, Universitiy of Veterinary Medicine Vienna, Austria
| | - S Kneissl
- Diagnostic Imaging, University of Veterinary Medicine Vienna, Austria
| | - B Lang
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - P Waters
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK
| | - S R Irani
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - S N M Binks
- Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU, UK; Department of Neurology, John Radcliffe Hospital, Oxford University Hospitals Foundation Trust, Oxford OX3 9DU, UK
| | - A Pakozdy
- Clinic for Small Animals, Internal Medicine, University of Veterinary Medicine Vienna, Austria
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Halstead SK, Gourlay DS, Penderis J, Bianchi E, Dondi M, Wessmann A, Musteata M, Le Chevoir M, Martinez-Anton L, Bhatti SFM, Volk H, Mateo I, Tipold A, Ives E, Pakozdy A, Gutierrez-Quintana R, Brocal J, Whitehead Z, Granger N, Pazzi P, Harcourt-Brown T, José-López R, Rupp S, Schenk HC, Smith P, Gandini G, Menchetti M, Mortera-Balsa V, Rusbridge C, Tauro A, Cozzi F, Deutschland M, Tirrito F, Freeman P, Lowrie M, Jackson MR, Willison HJ, Rupp A. Serum anti-GM2 and anti-GalNAc-GD1a IgG antibodies are biomarkers for acute canine polyradiculoneuritis. J Small Anim Pract 2022; 63:104-112. [PMID: 34791652 DOI: 10.1111/jsap.13439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 08/13/2021] [Accepted: 09/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES A previous single-country pilot study indicated serum anti-GM2 and anti-GA1 anti-glycolipid antibodies as potential biomarkers for acute canine polyradiculoneuritis. This study aims to validate these findings in a large geographically heterogenous cohort. MATERIALS AND METHODS Sera from 175 dogs clinically diagnosed with acute canine polyradiculoneuritis, 112 dogs with other peripheral nerve, cranial nerve or neuromuscular disorders and 226 neurologically normal dogs were screened for anti-glycolipid antibodies against 11 common glycolipid targets to determine the immunoglobulin G anti-glycolipid antibodies with the highest combined sensitivity and specificity for acute canine polyradiculoneuritis. RESULTS Anti-GM2 anti-glycolipid antibodies reached the highest combined sensitivity and specificity (sensitivity: 65.1%, 95% confidence interval 57.6 to 72.2%; specificity: 90.2%, 95% confidence interval 83.1 to 95.0%), followed by anti-GalNAc-GD1a anti-glycolipid antibodies (sensitivity: 61.7%, 95% confidence interval 54.1 to 68.9%; specificity: 89.3%, 95% confidence interval 82.0 to 94.3%) and these anti-glycolipid antibodies were frequently present concomitantly. Anti-GA1 anti-glycolipid antibodies were detected in both acute canine polyradiculoneuritis and control animals. Both for anti-GM2 and anti-GalNAc-GD1a anti-glycolipid antibodies, sex was found a significantly associated factor with a female to male odds ratio of 2.55 (1.27 to 5.31) and 3.00 (1.22 to 7.89), respectively. Anti-GalNAc-GD1a anti-glycolipid antibodies were more commonly observed in dogs unable to walk (OR 4.56, 1.56 to 14.87). CLINICAL SIGNIFICANCE Anti-GM2 and anti-GalNAc-GD1a immunoglobulin G anti-glycolipid antibodies represent serum biomarkers for acute canine polyradiculoneuritis.
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Affiliation(s)
- S K Halstead
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - D S Gourlay
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - J Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Stirling, FK7 7LE, UK
| | - E Bianchi
- Department of Veterinary Science, University of Parma, 43126, Parma, Italy
| | - M Dondi
- Department of Veterinary Science, University of Parma, 43126, Parma, Italy
| | - A Wessmann
- Neurology and Neurosurgery Service, Pride Veterinary Centre, Pride Park, Derby, DE24 8HX, UK
| | - M Musteata
- Neurology Service, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Iași, 700489, Romania
| | - M Le Chevoir
- Department of Neurology and Neurosurgery, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - L Martinez-Anton
- Chestergates Veterinary Specialists, Telford Court, Chestergates, CH1 6LT, UK
| | - S F M Bhatti
- Small Animal Department, Small Animal Teaching Hospital, Faculty of Veterinary Medicine, Ghent University, 9820, Merelbeke, Belgium
| | - H Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559, Hannover, Germany
| | - I Mateo
- Servicio de Neurología, Hospital Clínico Veterinario - Universidad Alfonso X el Sabio, Madrid, Spain
| | - A Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559, Hannover, Germany
| | - E Ives
- Anderson Moores Veterinary Specialists, Hursley, Winchester, SO21 2LL, UK
| | - A Pakozdy
- University Hospital for Small Animals, University of Veterinary Medicine, Vienna, Austria
| | | | - J Brocal
- Wear Referrals Veterinary Hospital, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - Z Whitehead
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa
| | - N Granger
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK.,CVS Referrals, Bristol Veterinary Specialists at Highcroft, Bristol, UK
| | - P Pazzi
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110, South Africa
| | - T Harcourt-Brown
- Langford Veterinary Services, School of Veterinary Sciences, University of Bristol, Lower Langford, BS40 5DU, UK
| | - R José-López
- School of Veterinary Medicine, University of Glasgow, Glasgow, G61 1QH, UK
| | - S Rupp
- Tierklinik Hofheim, 65719, Hofheim, Germany
| | - H C Schenk
- Tierklinik Lüneburg, 21337, Lüneburg, Germany
| | - P Smith
- Hamilton Specialist Referrals, Cressex Business Park, High Wycombe, HP12 3SD, UK
| | - G Gandini
- Department of Veterinary Medical Sciences, University of Bologna, 40064, Ozzano dell'Emilia, Italy
| | - M Menchetti
- Neurology and Neurosurgery Division, San Marco Veterinary Clinic, Veggiano, Italy
| | - V Mortera-Balsa
- North Downs Specialist Referrals, 3&4 The Brewerstreet Dairy Business Park, Bletchingley, Surrey, RH1 4QP, UK
| | - C Rusbridge
- Neurology Section, Fitzpatrick Referrals, Godalming, Surrey, GU2 7AL, UK.,School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7AL, UK
| | - A Tauro
- Chestergates Veterinary Specialists, Telford Court, Chestergates, CH1 6LT, UK
| | - F Cozzi
- Clinica Neurologica Veterinaria, 20148, Milan, Italy
| | | | - F Tirrito
- Clinica Neurologica Veterinaria, 20148, Milan, Italy
| | - P Freeman
- The Queen's Veterinary School Hospital, Cambridge, CB3 0ES, UK
| | - M Lowrie
- Dovecote Veterinary Hospital, Castle Donington, Derby, DE74 2LJ, UK
| | - M R Jackson
- Institute of Cancer Sciences, University of Glasgow, Bearsden, G61 1QH, UK
| | - H J Willison
- Neuroimmunology Laboratory, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, G12 8TA, UK
| | - A Rupp
- School of Veterinary Medicine, University of Glasgow, Glasgow, G61 1QH, UK
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Kitz S, Thalhammer JG, Glantschnigg U, Wrzosek M, Klang A, Halasz P, Shouse MN, Pakozdy A. Feline Temporal Lobe Epilepsy: Review of the Experimental Literature. J Vet Intern Med 2017; 31:633-640. [PMID: 28382749 PMCID: PMC5435036 DOI: 10.1111/jvim.14699] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 01/12/2017] [Accepted: 02/23/2017] [Indexed: 12/01/2022] Open
Abstract
Accumulating evidence suggests that epileptic seizures originating from the temporal lobe (TL) occur in cats. Typically, affected animals have clinically focal seizures with orofacial automatisms including salivation, facial twitching, lip smacking, chewing, licking, and swallowing. Motor arrest and autonomic and behavioral signs also may occur. Many affected cats have magnetic resonance imaging (MRI) changes within the hippocampus or histopathologically confirmed hippocampal sclerosis or necrosis. From the 1950s to the 1980s, cats frequently were used as animal models for neurophysiological experiments and electrophysiological studies, from which important basic knowledge about epilepsy originated, but which has been rarely cited in clinical veterinary studies. These studies were reviewed. Experimental research on cats showed the widespread anatomical connections among TL structures. The ictal clinical signs originating from the hippocampus, amygdala, or lateral temporal cortex are similar, because of their dense interconnections. The ictal signs can be divided into autonomic, somatic, and behavioral. For research purposes, a 6‐stage system was established, reflecting the usual sequential progression from focal to generalized seizure: attention response (1), arrest (2), salivation, licking (3), facial twitching (4), head turning or nodding (5), and generalized clonic convulsions (6). Knowledge of this data may help in recognizing low‐stage (stage 1 or stage 2) epileptic seizures in clinical practice. Early experimental research data are in accordance with recent clinical observations regarding ictal clinical signs of TL epileptic seizures in cats. Furthermore, the research data supports the idea that TL epilepsy represents a unique clinical entity with a specific seizure type and origin in cats.
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Affiliation(s)
- S Kitz
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - J G Thalhammer
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - U Glantschnigg
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - M Wrzosek
- Department of Internal Disease with Clinic of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - A Klang
- Pathology and Forensic Veterinary Medicine, University of Veterinary Medicine, Vienna, Austria
| | - P Halasz
- Institute of Experimental Medicine, Budapest, Hungary
| | - M N Shouse
- Department of Neurobiology, Center for Health Sciences, UCLA, Los Angeles, CA
| | - A Pakozdy
- Clinical Department for Companion Animals and Horses, Clinic for Small Animals Internal Medicine, University of Veterinary Medicine, Vienna, Austria
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Pakozdy A, Patzl M, Zimmermann L, Jokinen TS, Glantschnigg U, Kelemen A, Hasegawa D. LGI Proteins and Epilepsy in Human and Animals. J Vet Intern Med 2015; 29:997-1005. [PMID: 26032921 PMCID: PMC4895363 DOI: 10.1111/jvim.12610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/23/2015] [Accepted: 04/11/2015] [Indexed: 12/16/2022] Open
Abstract
Leucine‐rich glioma‐inactivated (LGI) protein was first thought to have a suppressor effect in the formation of some cancers. Developments in physiology and medicine made it possible to characterize the function of the LGI protein family and its crucial role in different conditions more precisely. These proteins play an important role in synaptic transmission, and dysfunction may cause hyperexcitability. Genetic mutation of LGI1was confirmed to be the cause of autosomal dominant lateral temporal lobe epilepsy in humans. The LGI2 mutation was identified in benign familial juvenile epilepsy in Lagotto Romagnolo (LR) dogs. Cats with familial spontaneous temporal lobe epilepsy have been reported, and the etiology might be associated with LGI protein family dysfunction. In addition, an autoimmune reaction against LGI1 was detected in humans and cats with limbic encephalitis. These advances prompted a review of LGI protein function and its role in different seizure disorders.
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Affiliation(s)
- A Pakozdy
- University Clinic of Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - M Patzl
- Institute of Immunology, University of Veterinary Medicine, Vienna, Austria
| | - L Zimmermann
- Unit of Physiology and Biophysics, University of Veterinary Medicine, Vienna, Austria
| | - T S Jokinen
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - U Glantschnigg
- University Clinic of Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - A Kelemen
- Epilepsy Center, National Institute of Clinical Neurosciences, Budapest, Hungary
| | - D Hasegawa
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, Musashinoshi, Tokyo, Japan
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5
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Klang A, Thaller D, Schmidt P, Kovacs GG, Halasz P, Pakozdy A. Bilateral Dentate Gyrus Structural Alterations in a Cat Associated With Hippocampal Sclerosis and Intraventricular Meningioma. Vet Pathol 2015; 52:1183-6. [PMID: 25572262 DOI: 10.1177/0300985814564979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 13-year-old cat had a history of seizures for 3 years that resembled temporal lobe epilepsy. Histologic examination of the brain revealed bilateral hippocampal alterations, including hypergyration and broadening of the dentate gyrus associated with hippocampal sclerosis and an intraventricular meningioma near the hippocampal region. The findings in the dentate gyrus were interpreted as a congenital malformation; however, it could not be ruled out that the alterations were induced by the seizures. Similar changes of the dentate gyrus have not been previously described in cats.
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Affiliation(s)
- A Klang
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - D Thaller
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - P Schmidt
- Institute of Pathology and Forensic Veterinary Medicine, Department for Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - G G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - P Halasz
- National Institute of Neuroscience, Budapest, Hungary
| | - A Pakozdy
- University Clinic for Small Animals, Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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