Publications by authors named "Bonny Alvarenga"

Article Synopsis
  • Vitamin B12 is essential for blood cell formation and nerve insulation, and its deficiency can lead to neurological issues despite normal blood levels, as seen in a patient with symptoms like tremor and cognitive decline.
  • Researchers discovered an autoantibody against the transcobalamin receptor (CD320) that hinders vitamin B12 uptake in the brain, resulting in low levels found in cerebrospinal fluid even when blood levels appear normal.
  • The study suggests this autoimmune condition can be treated with immunosuppressive therapy and high-dose vitamin B12, and highlights the importance of recognizing how B12 transport differs in various tissues, which could improve diagnosis and treatment strategies for similar neurological disorders.
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  • The study focuses on the detection of anti-TRIM9 and TRIM67 autoantibodies (TRIM9/67-IgG) in patients with paraneoplastic cerebellar syndrome, aiming to determine their diagnostic value and the most effective detection methods.
  • A retrospective analysis across multiple centers found that cell-based assays (CBA) were the most sensitive method for confirming the presence of TRIM9/67-IgG, identifying it in all tested cases (100%).
  • The findings indicate that a significant majority of patients with TRIM9/67-IgG had subacute cerebellar syndrome and were often associated with underlying cancers, reinforcing the idea of these auto
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Neuroinvasive infection is the most common cause of meningoencephalitis in people living with human immunodeficiency virus (HIV), but autoimmune etiologies have been reported. We present the case of a 51-year-old man living with HIV infection with steroid-responsive meningoencephalitis whose comprehensive pathogen testing was non-diagnostic. Subsequent tissue-based immunofluorescence with acute-phase cerebrospinal fluid revealed anti-neural antibodies localizing to the axon initial segment (AIS), the node of Ranvier (NoR), and the subpial space.

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  • Studies are needed to assess the safety and effectiveness of mRNA vaccines in pregnant individuals and how well antibodies are passed to newborns.
  • A study involving 20 individuals vaccinated late in pregnancy found no mRNA vaccine products in maternal or neonatal blood, but confirmed the efficient transfer of protective antibodies to newborns.
  • The timing of vaccination is important for ensuring that mothers can provide effective antibody protection to their infants through the placenta.
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Objective: To identify the autoantigen in 2 individuals with possible seronegative paraneoplastic neuropathy.

Methods: Serum and CSF were screened by tissue-based assay and panned for candidate autoantibodies by phage display immunoprecipitation sequencing (PhIP-Seq). The candidate antigen was validated by immunostaining knockout tissue and HEK 293T cell-based assay.

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  • The study analyzes the impact of various multiple sclerosis (MS) disease-modifying therapies (DMTs) on the immune response elicited by SARS-CoV-2 vaccination, comparing responses between healthy individuals and MS patients treated with different DMTs.
  • Findings indicate that while some DMTs (GA, DMF, NTZ) showed similar anti-spike antibody levels to healthy controls, treatments with anti-CD20 mAbs and S1P receptor modulators resulted in reduced antibody responses and compromised B cell activity.
  • T cell reactivity remained mostly robust across groups, although S1P-treated patients displayed weaker CD4+ T cell responses post-vaccination, emphasizing the need for tailored COVID-19 clinical guidelines based on
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Studies are needed to evaluate the safety and effectiveness of mRNA SARS-CoV-2 vaccination during pregnancy, and the levels of protection provided to their newborns through placental transfer of antibodies. We evaluated the transplacental transfer of mRNA vaccine products and functional anti-SARS-CoV-2 antibodies during pregnancy and early infancy in a cohort of 20 individuals vaccinated during pregnancy. We found no evidence of mRNA vaccine products in maternal blood, placenta tissue, or cord blood at delivery.

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Studies are needed to evaluate the safety and effectiveness of mRNA SARS-CoV-2 vaccination during pregnancy, and the levels of protection provided to their newborns through placental transfer of antibodies. We evaluated the transplacental transfer of mRNA vaccine products and functional anti-SARS-CoV-2 antibodies during pregnancy and early infancy in a cohort of 20 individuals vaccinated during pregnancy. We found no evidence of mRNA vaccine products in maternal blood, placenta tissue, or cord blood at delivery.

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The development of autoimmune antibody panels has improved the diagnosis of paraneoplastic neurological disorders (PNDs) of the brain and spinal cord. Here, we present a case of a woman with a history of breast cancer who presented with a subacute sensory ataxia that progressed over 18 months. Her examination and diagnostic studies were consistent with a myelopathy.

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Importance: Neuropsychiatric manifestations of COVID-19 have been reported in the pediatric population.

Objective: To determine whether anti-SARS-CoV-2 and autoreactive antibodies are present in the cerebrospinal fluid (CSF) of pediatric patients with COVID-19 and subacute neuropsychiatric dysfunction.

Design, Setting, And Participants: This case series includes 3 patients with recent SARS-CoV-2 infection as confirmed by reverse transcriptase-polymerase chain reaction or IgG serology with recent exposure history who were hospitalized at the University of California, San Francisco Benioff Children's Hospital and for whom a neurology consultation was requested over a 5-month period in 2020.

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Vaccine-elicited adaptive immunity is an essential prerequisite for effective prevention and control of coronavirus 19 (COVID-19). Treatment of multiple sclerosis (MS) involves a diverse array of disease-modifying therapies (DMTs) that target antibody and cell-mediated immunity, yet a comprehensive understanding of how MS DMTs impact SARS-CoV-2 vaccine responses is lacking. We completed a detailed analysis of SARS-CoV-2 vaccine-elicited spike antigen-specific IgG and T cell responses in a cohort of healthy controls and MS participants in six different treatment categories.

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Individuals with coronavirus disease 2019 (COVID-19) frequently develop neurological symptoms, but the biological underpinnings of these phenomena are unknown. Through single-cell RNA sequencing (scRNA-seq) and cytokine analyses of cerebrospinal fluid (CSF) and blood from individuals with COVID-19 with neurological symptoms, we find compartmentalized, CNS-specific T cell activation and B cell responses. All affected individuals had CSF anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies whose target epitopes diverged from serum antibodies.

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Comprehensive understanding of the serological response to SARS-CoV-2 infection is important for both pathophysiologic insight and diagnostic development. Here, we generate a pan-human coronavirus programmable phage display assay to perform proteome-wide profiling of coronavirus antigens enriched by 98 COVID-19 patient sera. Next, we use ReScan, a method to efficiently sequester phage expressing the most immunogenic peptides and print them onto paper-based microarrays using acoustic liquid handling, which isolates and identifies nine candidate antigens, eight of which are derived from the two proteins used for SARS-CoV-2 serologic assays: spike and nucleocapsid proteins.

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One third of COVID-19 patients develop significant neurological symptoms, yet SARS-CoV-2 is rarely detected in central nervous system (CNS) tissue, suggesting a potential role for parainfectious processes, including neuroimmune responses. We therefore examined immune parameters in cerebrospinal fluid (CSF) and blood samples from a cohort of patients with COVID-19 and significant neurological complications. We found divergent immunological responses in the CNS compartment, including increased levels of IL-12 and IL-12-associated innate and adaptive immune cell activation.

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