Immune cell profiling reveals expanded stem cell–like memory T cells in anti-GAD65-associated neurological syndromes
Abstract
The immunopathogenesis of autoimmune neurological syndromes (AINS) with antibodies against the 65 kDa isoform of glutamic acid decarboxylase (anti-GAD65 AINS) remains poorly understood. To elucidate underlying disease mechanisms and identify relevant cell populations, we performed single-cell RNA and immune repertoire sequencing of cerebrospinal fluid (CSF) and peripheral blood mononuclear cells (PBMCs) of eight anti-GAD65 AINS individuals compared to eight noninflammatory controls. In addition, PBMCs from 19 anti-GAD65 AINS individuals and 20 healthy controls were analyzed by multidimensional flow cytometry, and brain tissue specimens from four anti-GAD65 AINS individuals were examined histologically. We detected higher frequencies of stem cell–like memory T cells (TSCM) within the PBMCs and a marked enrichment and clonal expansion of activated CD4 + TSCM in the CSF of anti-GAD65 AINS individuals. Expanded T cells exhibited increased expression of proinflammatory genes. Histological analyses confirmed intraparenchymal CD8 + TSCM in three of four anti-GAD65 AINS individuals and rare meningeal/intraparenchymal CD4 + TSCM in one person. Although CSF B cell receptors (BCRs) displayed little to no clonal expansion, recombinant expression of 40 CSF BCRs revealed that 25% were GAD65-reactive with increased somatic hypermutations compared to non-GAD65-reactive BCRs. These findings further support the concept of an antigen-specific intrathecal immune response. In summary, we characterize the immune landscape of anti-GAD65 AINS at single-cell resolution and identify clonally expanded TSCM with cytotoxic properties as a hallmark of this disease.
Article Details
Journal Info
Proceedings of the National Academy of Sciences
National Academy of Sciences
Authors (298)
Sumanta Barman
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Martijn van Duijn
Department of Neurology, Erasmus MC University Medical Center
Madeleine Scharf
Institute for Experimental Immunology, affiliated to Euroimmun Medizinische Labordiagnostika Aktiengesellschaft
Marisol Herrera-Rivero
Institute of Epidemiology and Social Medicine, University of Münster
Paul Disse
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Lara-Maria Preuth
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Valeria Gulyaeva
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Ilja Schwan
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Eliza vom Stein
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Michael Heming
Department of Neurology, University Hospital Münster
Louisa Müller-Miny
Department of Neurology, University Hospital Münster
Manuela Paunovic
Department of Neurology, Erasmus MC University Medical Center
Ebru Haholu
Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München
Jan Bartosch
Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München
Elisabeth Kaufmann
Department of Neurology, University Hospital
Sabine Kahl
Institute for Clinical Diabetology, German Diabetes Center (Deutsches Diabetes-Zentrum), Leibniz Center for Diabetes Research at Heinrich Heine University
Eric Bindels
Department of Hematology, Erasmus MC University Medical Center
Heinz Wiendl
Institute for Neurology and Neurophysiology, Faculty of Medicine, University of Freiburg
Nikolas H. Stoecklein
Department of General, Visceral and Pediatric Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Johannes Fischer
Institute for Transplantation Diagnostics and Cell Therapeutics, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Norbert Goebels
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Lars Komorowski
Institute for Experimental Immunology, affiliated to Euroimmun Medizinische Labordiagnostika Aktiengesellschaft
Michael Roden
Institute for Clinical Diabetology, German Diabetes Center (Deutsches Diabetes-Zentrum), Leibniz Center for Diabetes Research at Heinrich Heine University
Andrea Rossi
Genome Engineering and Model Development Lab, Institut für umweltmedizinische Forschung-Leibniz Research Institute for Environmental Medicine
Monika Stoll
Department of Genetic Epidemiology, Institute of Human Genetics, University of Münster
Albert J. Becker
Institute of Cellular Neurosciences II, University Hospital Bonn
Motaz Hamed
Clinic for Neurosurgery, University Hospital of Bonn
Christian G. Bien
Department of Epileptology
Romana Höftberger
Division of Neuropathology and Neurochemistry, Department of Neurology and Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
Jan Bauer
Department of Neuroimmunology, Centre for Brain Research, Medical University of Vienna
Sven G. Meuth
Department of Neurology, Heinrich-Heine University Düsseldorf
Maarten J. Titulaer
Department of Neurology, Erasmus MC University Medical Center
Juna M. de Vries
Mariska M. P. Nagtzaam
Suzanne C. Franken
Yvette S. Crijnen
Juliette Brenner
Robin W. van Steenhoven
Jeroen Kerstens
Marienke A. A. M. de Bruijn
Anna E. M. Bastiaansen
Remco M. Hoogenboezem
Sharon Veenbergen
Peter A. E. Sillevis Smitt
Marwa Al-Dubai
Luise Appeltshauser
Ilya Ayzenberg
Carolin Baade-Büttner
Andreas van Baalen
Sebastian Baatz
Oliver Bähr
Bettina Balint
Iason Bartzokis
Sebastian Bauer
Annette Baumgartner
Tobias Baumgartner
Antonios Bayas
Stefanie Becker
Sonka Benesch
Robert Berger
Fachbereich Chemie, Theoretische Chemie, Philipps-Universität Marburg, Hans-Meerwein-Str. 4, 35032 Marburg, Germany
Birgit Berger
Martin Berghoff
Sarah Bernsen
Achim Berthele
Christian Bien
Corinna Bien
Julia Bierwith
Andreas Binder
Stefan Bittner
Daniel Bittner
Franz Blaes
Astrid Blaschek
Amelie Bohn
Moritz Böhringer
Marie Braun
Sergio Castro-Gomez
Justina Dargvainiene
Institute of Clinical Chemistry, University Hospital Schleswig-Holstein
Timo Deba
Julia Maren Decker
Johanna-Maria Dietmaier
Andre Dik
Julian Dominik
Kathrin Doppler
Mona Dreesmann
Lena Edelhoff
Laura Ehrhardt
Sven Ehrlich
Katharina Eisenhut
Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München
Alexander Emmer
Dominique Endres
Marina Entscheva-Storr
Daniela Esser
Institute of Clinical Chemistry, University Hospital Schleswig-Holstein
Thorleif Etgen
Jürgen Hartmut Faiss
Kim Kristin Falk
Timo Faustmann
Walid Fazeli
Alexander Finke
Carsten Finke
Felix Fischbach
Dirk Fitzner
Marina Flotats-Bastardas
Mathias Fousse
Tobias Freilinger
Manuel Friese
Hannah Fuhrer
Armin Johannes Gaebler
Marco Gallus
Marcel Gebhard
Christian Geis
Clemens Gödel
Anna Gorsler
Armin Grau
Oliver Grauer
Britta Greshake
Catharina roß
Thomas Grüter
Aiden Haghikia
Robert Handreka
Iris Hannibal
Niels Hansen
Institute of Thermodynamics and Thermal Process Engineering, University of Stuttgart, Pfaffenwaldring 9, Stuttgart 70569, Germany
Sandra Hansmann
Jens Harmel
Antonia Harms
Yetzenia Dubraska Haro Alizo
Alkomiet Hasan
Martin Häusler
Ida Sybille Haussleiter
Joachim Havla
Chung Ha-Yeun
Wolfgang Heide
Valentin Held
Kerstin Hellwig
Marina Herwerth
Philip Hillebrand
Frank Hoffmann
Christian Hofmann
Ulrich Hofstadt-van Oy
Dominica Hudasch (ehem. Ratuszny)
Yannik Hülsmann
Martinv Hümmert
Peter Huppke
Hagen Huttner
Fatme Seval Ismail
Martina Jansen
Mareike Jansen
Marius Jonas
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Aleksandra Juranek
Daniel Kamp
Michael Karenfort
Annika Kather
Max Kaufmann
Christoph Kellinghaus
Constanze Kerin (geb. Mönig)
Ruth Kerkhoff
Rolf Kern
Jaqueline Klausewitz
Michael Kluge
Susanne Knake
Benjamin Knier
Ellen Knierim
Frank Kohlert
Inga Koneczny
Felix Konen
Peter Körtvélyessy
Stjepana Kovac
Andrea Kraft
Markus Krämer
Verena Kraus
Christos Krogias
Gregor Kuhlenbäumer
Olga Kukhlenko
Tania Kümpfel
Albrecht Kunze
Hanna Lapp
Christoph Lehrich
Martin Lesser
Jan Lewerenz
Frank Leypoldt
Institute of Clinical Chemistry, University Hospital Schleswig-Holstein
Andreas Linsa
Daniel Lüdecke
Jan Lünemann
Marie Madlener
Michael Malter
Nils Margraf
Carlos Martinez Quesada
Monika Meister
Nico Melzer
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Kristin Stefanie Melzer
Til Menge
Sven Meuth
Gerd Meyer zu Hörste
Department of Neurology, University Hospital Münster
Fabian Möller
Marie-Luise Mono
Sigrid Mues
Hiltrud Muhle
Anna-Katharina Mundorf
Marc Nikolaus
Jost Obrocki
Friedemann Paul
Loana Penner
Lena Kristina Pfeffer
Thomas Pfefferkorn
Steffen Pfeuffer
Alexandra Philipsen
Johannes Piepgras
Julika Pitsch
Felix von Podewils
Mosche Pompsch
Josef Priller
Anne-Katrin Pröbstel
Harald Prüss
Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
Duygu Pul
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Daniel Rapp
Johanna Maria Helena Rau
Saskia Räuber
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Markus Rauchenzauner
Robert Rehmann
Ina Reichen
Gernot Reimann
Momsen Reincke
Raphael Reinecke
Jonathan Repple
Nele Retzlaff
Sigrid Reuter
Marius Ringelstein
Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University
Henrik Rohner
Felix Rosenow
Kevin Rostásy
Theodor Rüber
Stephan Rüegg
Yannic Saathoff
Jens Schaumberg
Hanna Schellhorn
Ruth Schilling
Jens Schmidt
Melissa Schmitz
Ina-Isabelle Schmütz
Hauke Schneider
Patrick Schramm
Stephan Schreiber
Stefanie Schreiber
Gesa Schreyer
Ina Schröder
Simon Schuster
Philip Schwenkenbecher
Günter Seidel
Frank Seifert
Thomas Seifert-Held
Makbule Senel
Kai Siebenbrodt
Olga Simova
Claudia Sommer
Juliane Spiegler
Oliver Stammel
Slobodan Stankovic
Andreas Steinbrecher
Johann Steiner
Henning Stolze
Muriel Stoppe
Karin Storm van’s Gravesande
Christine Strippel
Department of Neurology, University Hospital Münster
Dietrich Sturm
Klarissa Hanja Stürner
Kurt-Wolfram Sühs
Steffen Syrbe
Simone Taube
Franziska Thaler
Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität München
Florian Then Bergh
Katrin Thies
Anja Tietz
Corinna Trebst
George Trendelenburg
Regina Trollmann
Thanos Tsaktanis
Hayrettin Tumani
Mehtap Türedi
Christian Urbanek
Rem Vaizian
Niklas Vogel
Max Vogtmann
Matthias von Mering
Katharina von Zedtwitz
Judith Wagner
Jan Wagner
Elias Wagner
Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty University of Augsburg
Barbara Wagner
Klaus-Peter Wandinger
Mirko Wegschneider
Judith Weiser
Robert Weissert
Njiku Melchior Wellmer
Brigitte Wildemann
Jonathan Wickel
Karsten Witt
Katharina Wurdack
Yavor Yalachkov
Lara Zieger