Serum glial fibrillary acidic protein (GFAP)-antibody in idiopathic intracranial hypertension

Abstract

Aim

Idiopathic intracranial hypertension (IIH), a disease of obscure origin, is characterized by headache and visual disturbances due to increased intracranial pressure. Recent line of evidence has suggested involvement of inflammation in IIH pathogenesis thus bringing forward anti-glial autoimmunity as a potential contributor of IIH. Glial fibrillary acidic protein (GFAP) is a major astrocytic autoantigen associated with a specific form of meningoencephalitis.

Materials and methods

In this study, we investigated the presence of GFAP-antibody in 65 sera (49 obtained during active disease and 16 during remission) and in 15 cerebrospinal fluid (CSF) samples of 58 consecutively recruited IIH patients using cell based assay and indirect immunohistochemistry.

Results

GFAP-antibody was found in active period sera of 2 IIH patients with classical symptoms and good treatment response. Two remission period sera obtained at different time points from one of these cases showed lower titers of GFAP-antibody positivity. IgG from positive samples yielded an astrocytic immunoreactivity pattern. None of the CSF samples showed GFAP-antibodies.

Conclusions

These results suggest that anti-astrocyte autoimmunity might be present in a fraction of IIH patients. Exact pathogenic significance of this association needs to be further studied.

Keywords:

• Idiopathic intracranial hypertension
• glial fibrillary acidic protein
• antibody
• headache
• autoimmunity

Additional information

Funding

This study was supported by the Istanbul University Scientific Research Fund (grant number: 26443, 2017) and by a grant from the European Commission H2020 RISE Program (grant number: 645648, 2018).