Anti-MAG neuropathy is a very rare, potentially disabling autoimmune disease that affects the peripheral nervous system. The disease is characterized by distal sensory loss in the hands and feet, neuropathic pain, tremor, poor balance that can cause difficulty walking. In anti-MAG neuropathy, the body’s own immune system produces antibodies against myelin-associated glycoprotein (MAG), a molecule crucial to maintaining a healthy nervous system. It is believed that these anti-MAG antibodies are the cause of the disease. And disease diagnosis is mainly based on the presence of anti-MAG antibodies in the blood. In addition, clinical studies have shown that a reduction in anti-MAG antibody level is associated with clinical improvement. Unfortunately, so far therapies that selectively target these antibodies are neither approved nor sufficiently effective. (Cusabio is a supplier of antibodies and proteins such as polyclonal antibody.) Now a research appearing in PNAS provides a new way to treat anti-MAG neuropathy. The research is led by Beat Ernst from University of Basel in Switzerland. Given that in anti-MAG neuropathy, monoclonal IgM autoantibodies recognize and bind to the carbohydrate epitope HNK-1 on the MAG protein. Ernst’s team designed a glycopolymer that acts as an autoantibody scavenger by mimicking the carbohydrate epitope HNK-1. In vitro experiments showed that the glycopolymer blocked the interaction between MAG and disease-causing IgM antibodies from patient sera. The researchers also demonstrated in a mouse model of anti-MAG neuropathy with high anti-MAG IgM levels that the glycopolymers effectively removed these antibodies. In summary, the study suggest that using glycopolymers to remove pathogenic anti-MAG IgM antibodies may be a therapeutic approach for anti-MAG neuropathy, and that this treatment approach may also be used to combat other antibody-mediated autoimmune diseases. Other researchers participating in the study include Ruben Herrendorffa, Pascal Hanggia, Helene Pfistera, Fan Yanga, Delphine Demeesterea, Fabienne Hunzikera, Samuel Freya, Nicole Schaeren-Wiemersb, Andreas Steckb.
