AUTOIMMUNE MECHANISMS IN THE PATHOGENESIS OF PARANEOPLASTIC NERVOUS-SYSTEM DISEASE

There is compelling circumstantial evidence that humoral autoimmune re sponse may be involved in the generation of paraneoplastic neurologic syndromes (PNS). However, still it is unproven whether the autoantibod y is pathogenic or represents an epiphenomenon to the actual disease p rocess. Paraneoplastic antibodies have been identified in patients wit h PNS which react with similar antigenic epitopes in tumor and neurons . However, the antigens identified by the paraneoplastic antibodies ar e primarily intracellular in location, questioning the pathogenetic ro le of the antibody. The molecular events of antigen processing and pre sentation, T-cell receptor restriction, polyclonal B-cell proliferatio n, cellular immunity, and the role of cytokines in mediation of neuron al injury must be further defined in order to elucidate the role of au toimmunity in the pathogenesis of these disorders.