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Hannah L. Pellkofer, MD; Raymond Voltz, MD; Norbert Goebels, MD; Reinhard Hohlfeld, MD; Klaus Dornmair, PhD

Arch Neurol. 2009;66(5):655-658.

Background  According to established criteria, paraneoplastic encephalomyelitis with adrenal neuroblastoma comprises a definite paraneoplastic neurologic syndrome.

Objective  To detect T-cell clones that cross-react against antigens shared between tumor and nervous system.

Design  Case study.

Setting  Academic research.

Patient  A 22-year-old woman having paraneoplastic encephalomyelitis with adrenal neuroblastoma.

Main Outcome Measures  We compared the T-cell receptor repertoires expressed in blood, cerebrospinal fluid, and neuroblastoma tumor tissue using complementary determining region 3 (CDR3) spectratyping and clone-specific polymerase chain reaction.

Results  The T-cell receptor repertoire in cerebrospinal fluid was narrow compared with that in tumor and blood. Four T-cell clones from different tissues had identical T-cell receptor β chains. Remarkably, the chains showed identical amino acid sequences but different nucleotide sequences.

Conclusions  These T cells represent ontogenetically distinct clones but share functionally identical receptors. They recognize the same antigen in nervous system and tumor tissue and represent an attractive target for selective therapy.

Author Affiliations: Institute of Clinical Neuroimmunology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich (Drs Pellkofer, Hohlfeld, and Dornmair), Department of Neuroimmunology, Max Planck Institute for Neurobiology, Martinsried (Drs Hohlfeld and Dornmair), and Department of Palliative Medicine, University Hospital, University of Cologne, Cologne (Dr Voltz), Germany; and Neurological Clinic, University Hospital Zurich, Zurich, Switzerland (Dr Goebels).

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RELATED LETTERS

Notice of Incomplete Referencing
Roger N. Rosenberg
Arch Neurol. 2009;66(10):1299-1300.
EXTRACT | FULL TEXT  

Notice of Incomplete Referencing—Reply
Raymond Voltz
Arch Neurol. 2009;66(10):1300.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Notice of Incomplete Referencing
Rosenberg
Arch Neurol 2009;66:1299-1300.
FULL TEXT  

Notice of Incomplete Referencing--Reply
Voltz
Arch Neurol 2009;66:1300-1300.
FULL TEXT