Autoantibodies in Neurological Disease
Numerous autoantibodies types can target different cells and their components within the nervous system, leading to wide array of symptoms (Pruss, 2015). For example, myelin oligodendrocyte glycoprotein (MOG) autoantibodies target the myelin sheath of axons and induce FcR-mediated antibody-dependent cellular cytotoxicity (Brilot, 2009). Further, autoantibodies may target the myelin of the 8thcranial nerve, leading to vestibular dysfunction (Girasoli et al, 2018). In my case, I had symptoms of tinnitus, vestibular dysfunction such as dizziness, vertigo, and loss of balance, along with nystagmus and therefore degraded visual acuity. No hearing loss at any frequency was observed. The constellation of symptoms suggested that the vestibulocochlear nerve was targeted, possibly the myelin (Di Pauli and Berger, 2018). Autoantibodies against human epithelial cells and endothelial cells have been found to develop after SARS‐CoV infection (Yang et al, 2005). In my case, long-term blistering of the gums and mouth cavity has occurred for many months, and the symptoms spike at times and are correlated with spikes of the symptoms associated with autoantibodies targeting the 8th cranial nerve. Elevated frequencies of IgD−CD27− double negative B cells (DN B cells) with pro-inflammatory characteristics could be triggered because prolonged inflammatory cytokines, IL-6, IL-15, IL-8 (Frausen et al, 2019). This autoantibody type has frequently been found proximally at the site of lesions, including in the brain and CSF of MS patients (Baranzini et al, 1999; Qin et al, 2003). While the targets of antibodies released from these cells has not been described, immune reactivity against key myelin protein types by autoantibodies has been described in autoimmune patients (Mazón-Cabrera et al, 2019).