How the KIR4.1 Autoantibody Could Change the Diagnosis and Treatment of MS

A team of scientists from the University of Munich recently published a paper in the New England Journal of Medicine reporting that they may have found an autoantibody linked to multiple sclerosis. The results of their research were recently presented at the American Academy of Neurology’s 66th Annual Meeting in Philadelphia, PA. In their study they found that almost half of people with MS had detectable levels of the KIR4.1 autoantibody in their blood years before developing MS. During the study they tested the blood of 16 blood donors who later developed MS for the KIR4.1 autoantibody and found that 7 people tested positive, 2 were borderline and, 7 were negative. Additionally, autoantibodies were not present in any of the blood samples taken from healthy people. So what is KIR4.1 and what does this mean to the MS community?

Despite its complicated sounding name, KIR4.1 is simply a protein. In humans proteins are essential molecules and they are involved in almost every process within our bodies. There are hundreds of thousands of proteins in the human body, and each one has its own job. The KIR4.1 protein is essential in the formation of myelin, and our brains need KIR4.1 in order to make the myelin that forms the protective covering around our nerves. A normal, healthy immune system fights off infections and foreign invaders with weapons known as antibodies. However, in some people, the immune system malfunctions. If your immune system mistakenly attacks your own proteins or cells thinking they are foreign invaders, then the antibodies used to attack them are called autoantibodies. This is what causes autoimmune diseases where your body attacks itself and is responsible for many different diseases. MS is a complicated autoimmune disease, and the team from the University of Munich has convincing data that suggest autoantibodies against KIR4.1 play an important role in the inflammatory process and tissue damage that occurs with MS.

Knowing that KIR4.1 autoantibodies exist and play a role in MS could help doctors in a couple of ways. First, it would allow us to have a blood test for MS. When we are doing other diagnostic studies such as lumbar punctures and MRIs, we can also test for the presence of KIR4.1 autoantibodies in the blood. But, according to the study not all MS patients have these antibodies. Knowing this could allow us to not only classify MS as relapsing remitting or progressive, but also as “autoantibody positive” or “autoantibody negative”. This could help us choose medications that will work better for each individual patient. Other diseases have similar autoantibodies that have helped in finding effective treatments. Myesthenia Gravis (MG) is an example of a neurological disease that we treat based on the presence or absence of autoantibodies. MG has many subtypes including autoantibody negative and autoantibody positive. The patient is then treated with different medications based on their subgroup to get the best results. The hope is that we will be able choose the best medications for MS patients based on autoantibodies such as KIR4.1. If MS really does have different subgroups this could help explain why MS is so different from patient to patient, and why certain medications work for some but not others.

The big question is how long are KIR4.1 autoantibodies detectable in the blood before someone develops MS? Knowing the answer to this question could help us identify “pre-MS” and may even let us intervene before the disease develops and or before it has the chance to cause significant damage. Larger studies will be needed to know for sure.1-5

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View References
  1. Brooks M. KIR4.1 Antibodies in Blood May Precede MS by Years. Medscape Medical News from the. American Academy of Neurology (AAN) 66th Annual Meeting. Article 821075. February 25, 2014.
  2. Gilhus NE. Advances in the Treatment of Myasthenia Gravis. Future Neurology. 2012;7:701-708.
  3. KIR4.1 antibodies: A revolution in multiple sclerosis. Neuroimmunology Blog. http://neuroimmunology.wordpress.com/2012/07/16/kir4-1-antibodies-a-revolution-in-multiple-sclerosis/. Accessed May 8, 2014.
  4. Schneider R. Autoantibodies to potassium channel KIR4.1 in multiple sclerosis. front neurol. 2013; 4:125.
  5. Scutti S. MS symptoms may be predicted by antibody detected in your blood years before warning signs appear. Medical Daily. February 21, 2014.

Comments

View Comments (4)
  • Carol
    5 years ago

    Would it be appropriate for me to ask my neurologist to have this blood test done? Is it covered by most insurance companies? If not covered, how much does it usually cost? I am very interested in this topic. Thank you for this article, as it is very informative!

  • Stephanie Buxhoeveden, RN, MSCN author
    5 years ago

    Hi Carol,

    I consulted Labcorp and Quest Diagnostics and it does not appear this is a commercially available blood test yet. You should ask your neurologist what they know about it though!

  • Kim Dolce moderator
    5 years ago

    Stephanie,

    Thank you for writing about this study, I wasn’t aware of it. So many of us have wondered why signs of MS can’t be detected in the blood. I hope this will be the tip of the iceberg as far as adding more testing to pinpoint which therapies we should start early on, thereby saving us a lot of time, money, and further disability.

    Kim

  • Stephanie Buxhoeveden, RN, MSCN author
    5 years ago

    Thank you KIm. Imagine a world where MS could be diagnosed based by simply having a blood test and and MRI, it would save a lot of us from going through many invasive tests!

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