Publications
Neurofascin 155, 186 and 140 Antibodies in Patients with Multiple Sclerosis: A Pilot Prospective Exploratory Study
Thomas Mathew 1 , Surabhi Garg 1 , Pritam Majumdar 1 , Shagun Bhardwaj 1 , Sudheeran Kannoth 2 , Annamma Mathai 2 , Sumithra Selvam 3 , Molly George 1 , Uday Murgod 4 , Vikram Kamath 5 , Subhash Kaul 6 , Sindhu V Nambiar 1 , Akshata Huddar 1 , Sonia Shivde 1 , Sagar Badachi 1 , Raghunandan Nadig 1 , Sharath Gg Kumar 1 , Sai Kanth Deepalam 1 , Grk Sarma 1 Background: Antineurofascin antibodies (ANFA) have been identified in central and peripheral demyelinating disorders. We present the results of pan-ANFA assay targeting neurofascin (NF) 155, 186, and 140, in a cohort of Indian Multiple Sclerosis (MS) patients.
Objective: To assess the presence of antineurofascin antibodies (ANFA) 155, 186, and 140 in patients with MS.
Methodology: In this multicenter prospective study, we investigated the presence of antibodies targeting NF155, NF186, and NF140 in Indian MS patients satisfying McDonald's 2017 criteria. ANFA was measured by competitive ELISA technique using human neurofascins.
Results: During the 11-month period from November 1, 2023, to September 30, 2024, we tested 71 MS patients for ANFA. Of the 71 MS patients, 57 (80.28%) tested positive for at least one antineurofascin antibody and 15 (21.13%) were positive for two antibodies. Isolated ANFA140 was present in 26 (36.62%) patients, isolated ANFA186 in 13 (18.31%), and isolated ANFA155 in 3 (4.23%). Combined ANFA 186/140 was present in 14 (19.72%) patients and combined ANFA 155/140 in 1 (1.41%).
Conclusion: Antibodies to at least one of the neurofascin antigens were present in a significant number of Indian MS patients. ANFA to NF140 and NF186 was found to be more prevalent compared with ANFA against NF155. Further immunological and molecular investigations are required to confirm whether these antibodies are truly pathogenic, disease-modifying, or incidental.
