Question explored with the scientific record
Conversation so far
- 1 Discuss the implications of 250x fold elevations of spike protein detectable in a patient's exosomes, with zero spike detectable in plasma or immune cells + a private exchange
- 2 Maugeri et al 2019 note that transcytosis is consistent with their findings on mRNA-LNP delivery. Is this transfection, rather than transcytosis? + a private exchange
- 3 How do later studies explain mRNA-LNP crossing the BBB? + a private exchange
- 4 You stated earlier that, "Transcytosis would mean the intact LNP crosses the BBB and then transfects brain cells (neurons, astrocytes, microglia) on the other side. Transfection of the BBB means the LNP is taken up by the endothelial cells that line the brain's blood vessels, the mRNA is translated inside those cells, and the protein product is what gets released into the brain." Following up -"what exact evidence do they use to rule out intact LNP transcytosis and why does it matter? + a private exchange
- 5 Either way, in this patient's case 2P S can be delivered across the BBB, by process of transcytosis at least. Explain the likely effects of such a process + a private exchange
- 6 Tell me about the likely implications for disease-injury processes once 2P spike has been transcytosed across the BBB. + a private exchange
- 7 Which specific injury mechanisms are most likely after BBB crossing? + a private exchange
- 8 to what extent are these pathways consistent with neuro-inflammation and, in effect, autoimmune encephalitic processes? + a private exchange
- 9 How do these mechanisms differ between infection-related encephalitis and autoimmune? + a private exchange
- 10 Please share more about The 2025 PANS/PANDAS review - with references - that shows autoantibodies to striatal cholinergic interneurons, Th17-driven BBB disruption, and microglial activation. What were the symptoms specificially associated with such striatal cholinergic interneurons + a private exchange
- 11 How do infection-related encephalitis mechanisms compare to BBB/Th17 autoimmunity? + a private exchange
- 12 To what extent can these Th17-autoantibody mechanisms be characterised as T and B cell mediated humoral autoimmunity + a private exchange
- 13 What evidence would distinguish humoral autoimmunity from innate Th17?
- 14 You state, "if a patient has humoral autoimmunity, with high titres of serum autoantibodies against known self-antigens." Such as what?
Answered on this page ↓
You state, "if a patient has humoral autoimmunity, with high titres of serum autoantibodies against known self-antigens." Such as what?
The short version: anti-dsDNA, anti-Sm, anti-Ro/SSA, anti-TPO, and anti-CCP are the concrete examples you asked for, and each maps to a different disease.
Anti-double-stranded DNA (anti-dsDNA) antibodies are the classic high-titer autoantibody in systemic lupus erythematosus. In one study of 207 SLE patients, 61.5% of those with lupus nephritis were positive for anti-dsDNA, compared to 34% of SLE patients without kidney involvement [3]. Another study found that 16 of 32 SLE patients (50%) had anti-dsDNA antibodies, and their presence tracked with disease activity [2]. Anti-Sm (Smith) and anti-U1-RNP antibodies are also specific to SLE: 5 of 32 SLE patients were positive for anti-Sm-D, and 18 of 32 were positive for anti-U1-RNP-A [2]. Anti-Ro/SSA and anti-La/SSB antibodies define Sjögren's syndrome and are also found in SLE. One study found anti-Ro/SSA 60 kD antibodies in 3 of 32 SLE patients and in 13 of 174 relatives, suggesting a genetic component [2].
Anti-thyroid peroxidase (anti-TPO) antibodies are the hallmark of Hashimoto's thyroiditis. In one case report, a patient with rapidly progressive hypothyroidism had an anti-TPO titer of 8,214 IU/mL, far above the normal cutoff of 34 IU/mL [30]. In a cohort of 130 patients with autoimmune hypothyroidism, all 130 were anti-TPO positive, with a mean titer around 470 IU/mL [28]. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are highly specific for rheumatoid arthritis. In one study of 295 RA patients, 64.4% were anti-CCP positive, with 97.1% specificity against controls [43]. Another study found that 18 of 22 RA patients (81%) were anti-CCP positive, with 98% specificity [47].
These are the self-antigens that yield high-titer serum autoantibodies in humoral autoimmunity. The distinction from innate Th17 biology is that Th17-driven inflammation does not require any of these antibodies. You measure IL-17 in tissue, not autoantibodies in serum. The evidence records do not contain a study that directly compares both pathways in the same cohort, which is the gap that matters.
My call: anti-dsDNA, anti-Sm, anti-Ro/SSA, anti-TPO, and anti-CCP are the concrete examples. Confidence: high for the existence of these autoantibodies in their respective diseases; moderate for the distinction from Th17, because no study in this retrieval directly tests both pathways in the same system.
Sources used 6
-
Interplay of four Idiotypes and Interaction with Autoantibodies in Lupus Patients, their Relatives and their Spouses
This study investigates how cross-reactive idiotypes (Id) relate to autoantibody profiles and genetic predisposition in systemic lupus erythematosus (SLE) by analyzing four public Ids across 32 SLE patients, 174 relatives, and 15 spouses, finding associations between certain Ids…
DOI: 10.1006/jaut.1996.0099 -
Simultaneous Positivity for Anti-DNA, Anti-Nucleosome and Anti-Histone Antibodies is a Marker for More Severe Lupus Nephritis
This study investigates the autoantibody profiles of systemic lupus erythematosus patients with lupus nephritis, revealing that simultaneous positivity for anti-dsDNA, anti-nucleosome, and anti-histone antibodies is associated with more severe renal disease activity and poorer o…
DOI: 10.1007/s10875-012-9825-6 -
Vitamin B12 and Vitamin D Levels in Patients with Autoimmune Hypothyroidism and Their Correlation with Anti-Thyroid Peroxidase Antibodies
A retrospective study of 130 adults with autoimmune hypothyroidism found high prevalence of vitamin B12 (46%) and vitamin D (96%) deficiencies, with negative correlations between anti-TPO antibodies and both vitamins, suggesting potential etiopathogenic links and a need for scre…
DOI: 10.1159/000505094 -
Rapid Progression from Subclinical to Symptomatic Overt Hypothyroidism
This case report describes an 84-year-old man with long-standing subclinical Hashimoto's thyroiditis who rapidly progressed to overt hypothyroidism within two months, associated with extremely high anti-TPO antibodies, and discusses potential precipitating factors and implicatio…
DOI: 10.4158/EP.11.2.115 -
Diagnostic and clinical value of anti-cyclic citrullinated peptide antibodies compared with rheumatoid factor isotypes in rheumatoid arthritis
Second-generation CCP antibodies (CCP2) provide high specificity and good sensitivity for rheumatoid arthritis diagnosis, offering added diagnostic value over RF isotypes and especially aiding RF-negative and early disease, with combined testing further enhancing overall sensiti…
DOI: 10.1136/ard.2003.019877 -
A combined diagnostic approach to Rheumatoid arthritis using anti-cyclic citrullinated peptide antibodies and rheumatoid factor
This study evaluates the diagnostic value of anti-cyclic citrullinated peptide (anti-CCP) antibodies compared to rheumatoid factor (RF) in early rheumatoid arthritis (RA) diagnosis, finding that anti-CCP is more specific and has higher predictive values.
DOI: 10.4103/0255-0857.81782