• J. Neurol. Neurosurg. Psychiatr. · Sep 2013

    TDP-43 frontotemporal lobar degeneration and autoimmune disease.

    • Zachary A Miller, Katherine P Rankin, Neill R Graff-Radford, Leonel T Takada, Virginia E Sturm, Clare M Cleveland, Lindsey A Criswell, Philipp A Jaeger, Trisha Stan, Kristin A Heggeli, Sandy Chan Hsu, Anna Karydas, Baber K Khan, Lea T Grinberg, Maria Luisa Gorno-Tempini, Adam L Boxer, Howard J Rosen, Joel H Kramer, Giovanni Coppola, Daniel H Geschwind, Rosa Rademakers, William W Seeley, Tony Wyss-Coray, and Bruce L Miller.
    • UCSF Memory and Aging Center, University of California San Francisco, San Francisco, California 94143-1207, USA. zmiller@memory.ucsf.edu
    • J. Neurol. Neurosurg. Psychiatr. 2013 Sep 1; 84 (9): 956-62.

    BackgroundThe aetiology and pathogenesis of non-genetic forms of frontotemporal dementia (FTD) is unknown and even with the genetic forms of FTD, pathogenesis remains elusive. Given the association between systemic inflammation and other neurodegenerative processes, links between autoimmunity and FTD need to be explored.ObjectiveTo describe the prevalence of systemic autoimmune disease in semantic variant primary progressive aphasia (svPPA), a clinical cohort, and in progranulin (PGRN) mutation carriers compared with neurologically healthy normal controls (NC) and Alzheimer's disease (AD) as dementia controls.DesignCase control.SettingAcademic medical centres.Participants129 svPPA, 39 PGRN, 186 NC and 158 AD patients underwent chart review for autoimmune conditions. A large subset of svPPA, PGRN and NC cohorts underwent serum analysis for tumour necrosis factor α (TNF-α) levels.Outcome Measuresχ(2) Comparison of autoimmune prevalence and follow-up logistic regression.ResultsThere was a significantly increased risk of autoimmune disorders clustered around inflammatory arthritides, cutaneous disorders and gastrointestinal conditions in the svPPA and PGRN cohorts. Elevated TNF-α levels were observed in svPPA and PGRN compared with NC.ConclusionssvPPA and PGRN are associated with increased prevalence of specific and related autoimmune diseases compared with NC and AD. These findings suggest a unique pattern of systemic inflammation in svPPA and PGRN and open new research avenues for understanding and treating disorders associated with underlying transactive response DNA-binding protein 43 aggregation.

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