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Exploring the Role of Autoantibodies in Pain Conditions: Clinical and Preclinical Findings
Session Description
This workshop will update clinicians and basic researchers about emerging neuroimmunology research to highlight new clinical and research opportunities. Basic research approaches using patient specimens have already proven that specific neuropathies are maintained by pathological antibodies targeting cells in symptom-associated pathways. Rapid, accurate diagnosis enables consideration of targeted mechanism-based therapies available today with clinical-trial efficacy data. We will mention the classic dysimmune neuropathies but focus on the more recent evidence in painful disorders including peripheral neuropathies and fibromyalgia. We will review the methods and conclusions from experiments analysing samples from patients that demonstrate causality and elucidate pathological mechanisms. These include in vitro studies and passive-transfer models in vivo, where antibodies from patients are administered to mice that develop behavioural, anatomical, and physiological correlates of human pain syndromes. In vitro assays effectively identify putative pathogenic antibodies and targets, and passive-transfer approaches are the gold-standard for proving autoimmune causality. Both have yielded mechanistic advances with high degrees of predictive validity. We will end by discussing less-certain topics including which other chronic pain conditions have lesser evidence of dysimmune contributions, steps in clinical diagnostic pathways, the best-established immunotherapies, when immunotherapy is not appropriate to consider. Emerging research opportunities will be highlighted.