In paraneoplastic neurological syndromes associated with Hu-antibodies (Hu-PNS) an important role for cellular immunity is hypothesized. We characterized the cerebrospinal fluid (CSF) pleocytosis in Hu-PNS patients by assessing the major lymphocyte subsets by flow cytometry. The B cell subset in the CSF of Hu-PNS patients showed a significant absolute (~ 20×) and relative (~ 3×) expansion, while the numbers of CD4+ T cells, CD8+ T cells and NK cells only showed an absolute expansion (~ 4-7×) compared to the controls. On the other hand, the NKT cell subset showed a significant relative reduction in CSF and in blood of Hu-PNS patients. The relative B cell expansion is consistent with the intrathecal synthesis of Hu-antibodies, while the increased number of T and NK cells supports an additional role for cellular immunity in the pathogenesis of Hu-PNS. In addition, the autoimmune hypothesis of Hu-PNS is supported by the relative NKT cell deficiency.

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Keywords Cancer, Cerebrospinal fluid, Hu-antibody, Lymphocyte subsets, Paraneoplastic neurological syndromes
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Journal Journal of Neuroimmunology
de Graaf, M.T, de Beukelaar, J.W.K, Bergsma, J, Kraan, J, van den Bent, M.J, Klimek, M, … Gratama, J.W. (2008). B and T cell imbalances in CSF of patients with Hu-antibody associated PNS. Journal of Neuroimmunology, 195(1-2), 164–170. doi:10.1016/j.jneuroim.2008.01.007