抗caspr2自身抗体在躯体症状障碍伴医学上无法解释的疼痛患者中的患病率

IF 3.7 Q2 IMMUNOLOGY

Brain, behavior, & immunity - health Pub Date : 2025-06-16 DOI:10.1016/j.bbih.2025.101036

Shingo Katayama , Gayatri Nayanar , Takayuki Suga , Motoko Watanabe , Chihiro Takao , Yojiro Umezaki , Hidehiko Takahashi , Akira Toyofuku , Hiroki Shiwaku

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引用次数: 0

摘要

医学上无法解释的伴有疼痛的症状（MUS）在精神病学领域被归类为伴有疼痛的躯体症状障碍（SSD），尽管至少其中一些病例可能存在未被发现的生物学基础。其中一个候选病因是自身抗体。在伴有疼痛的MUS中，包括纤维肌痛，怀疑自身抗体病因，这与伴有疼痛的SSD高度相关。此外，已知抗接触相关蛋白样2 （CASPR2）的自身抗体可诱导神经病变和疼痛，但没有研究检测抗CASPR2自身抗体在伴有疼痛的SSD患者中的患病率或临床意义。因此，本研究旨在探讨抗caspr2自身抗体在伴有疼痛的SSD患者中的血清阳性率及其与疾病特征的关系。方法采用细胞法筛选264例伴有疼痛的SSD患者和260例健康对照者的血清中抗caspr2自身抗体。在纳入的264例患者中，使用视觉模拟量表（VAS）、疼痛灾难量表（PCS）和躯体症状量表-8 （SSS-8）评估231例口腔感觉不良（包括口腔淋巴结病）的临床症状严重程度。结果264例患者中，抗caspr2自身抗体血清阳性18例（6.8%）。231例口腔感觉不良患者中，12例（5.4%）抗caspr2自身抗体阳性。抗caspr2自身抗体阳性的口腔感觉不良患者的SSS-8评分明显高于自身抗体阴性的患者。结论在伴有医学原因不明疼痛的SSD患者中，一小部分患者抗caspr2自身抗体血清阳性。

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Prevalence of the anti-CASPR2 autoantibody in patients with somatic symptom disorder accompanied by medically unexplained pain

Background

Medically unexplained symptoms (MUS) with pain are classified as somatic symptom disorder (SSD) with pain in the field of psychiatry, although an undetected biological basis may underlie at least some of these cases. One such candidate etiology is autoantibodies. Autoantibody etiologies are suspected in MUS with pain, including fibromyalgia, which is highly related to SSD accompanied with pain. Furthermore, autoantibodies against contactin-associated protein-like 2 (CASPR2) are known to induce neuropathy and pain, yet no study has examined the prevalence or clinical significance of anti-CASPR2 autoantibodies in patients with SSD accompanied with pain. Thus, the current study aims to investigate the seroprevalence of the anti-CASPR2 autoantibody among patients with SSD accompanied with pain and their associations with disease characteristics.

Methods

The serum samples obtained from 264 patients with SSD accompanied with pain and 260 healthy controls were screened for anti-CASPR2 autoantibodies using a cell-based assay. Among the 264 patients enrolled, 231 with oral dysesthesia (including oral cenesthopathy) were assessed for clinical symptom severity using the Visual Analog Scale (VAS), Pain Catastrophizing Scale (PCS), and Somatic Symptom Scale-8 (SSS-8).

Results

Of the 264 patients, 18 (6.8 %) tested seropositive for anti-CASPR2 autoantibodies. Among the 231 patients with oral dysesthesia, 12 (5.4 %) were positive for anti-CASPR2 autoantibodies. These patients with oral dysesthesia who were positive for anti-CASPR2 autoantibody reported significantly higher SSS-8 scores than those who were negative for autoantibody.