Anti-sulfatide antibodies in neurological disorders: should we test?

J Neurol. 2024 Dec;271(12):7613-7618. doi: 10.1007/s00415-024-12668-8. Epub 2024 Sep 3.

Abstract

Objective: Neurological autoimmune peripheral and central nervous system disorders can be associated with anti-sulfatide antibodies. These antibodies are considered potential diagnostic biomarkers, although their additional diagnostic value in neurological fields has been increasingly questioned. Given the little evidence of anti-sulfatide antibodies' frequency and diagnostic value in neurology, we aimed to fill this knowledge gap by investigating 10 years of data.

Methods: This retrospective study analyzed the results of the anti-ganglioside dot kits (GA Generic Assays GmbH) from 1318 serum samples and 462 cerebrospinal fluid (CSF) samples for the frequency, sensitivity, and specificity of anti-sulfatide antibodies in neurological disorders.

Results: Although anti-sulfatide antibodies are rarely present in neurological autoimmune disorders (serum IgM 2.5%, IgG 4.6%), they are also present in non-autoimmune diseases (serum IgM 1.2%, IgG 2.5%) and lack sensitivity and specificity towards being a diagnostic marker. Furthermore, anti-sulfatide antibodies are rarely found in CSF (e.g., no positive results for IgM), and including so-called borderline results ((+)) increases sensitivity and the false-positive rate in serum and CSF.

Discussion: While anti-sulfatide antibodies appear more frequently in neurological autoimmune diseases, they are rare overall and provide very limited diagnostic value in determining specific neurological diseases and-more importantly-if a neurological disease has a potential autoimmune etiology.

Keywords: Anti-sulfatide antibodies; Autoimmune; Neurological disorders; Sulfatide.

MeSH terms

  • Autoantibodies* / blood
  • Autoantibodies* / cerebrospinal fluid
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / cerebrospinal fluid
  • Immunoglobulin M / blood
  • Immunoglobulin M / cerebrospinal fluid
  • Male
  • Nervous System Diseases / blood
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / immunology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sulfoglycosphingolipids* / blood
  • Sulfoglycosphingolipids* / immunology

Substances

  • Sulfoglycosphingolipids
  • Autoantibodies
  • Biomarkers
  • Immunoglobulin M
  • Immunoglobulin G