[Autoimmune mechanisms in the pathogenesis of neurologic paraneoplastic diseases].

Neurologic paraneoplastic syndromes (NPS) are disorders of the nervous system that are associated with the presence of malignant tumors. They are also known as the remote effects of cancer. There is mounting circumstantial evidence supporting the autoimmune origin of NPS. In NPS patients, paraneoplastic autoantibodies have been identified which react with the same or similar antigenic epitopes in tumor cells and neurons. However, except for the Lambert-Eaton myasthenic syndrome (LEMS) it remains still unproven as to whether the autoantibodies are pathogenic or merely represent an epiphenomenon to the actual disease process, since the antigens identified by the paraneoplastic autoantibodies are primarily intracellular as to their location. Few data are available regarding the role of cell-mediated cytotoxicity and antigen dependent T-cell cytotoxicity. Further studies will be necessary to elucidate the role of autoimmunity in the production of paraneoplastic neurologic disorders. (Tab. 2, Ref. 6.)