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Page 2 of 3 Goncalves et al. Neuroimmunol Neuroinflammation 2019;6:6 I http://dx.doi.org/10.20517/2347-8659.2019.08

Figure 1. Neurofascin 155 (NF155) is a transmembrane adhesion molecule located in the paranodal region in the central (CNS)
and peripheral nervous system (PNS), justifying the various clinical presentations. CIDP: chronic inflammatory demyelinating
polyradiculoneuropathy; MS: multiple sclerosis

may present demyelinating lesions in the central nervous system, along with a remarkably poor response
[12]
to intravenous courses of immunoglobulin . Overall, patients with CIDP with overlapping central and
peripheral demyelination associated with presence of anti-NF155 antibodies exhibit greater disability.

In addition to the peculiarities of peripheral demyelination associated with presence of NF155 antibodies,
diseases of the central nervous system also show particular features when anti-NF155 antibodies are
[13]
identified. Ten percent of patients fulfilling the diagnostic criteria for MS , may have antibodies against
[14]
NF155 . Cases of neurological disease with onset typical of MS that were subsequently diagnosed as CIDP
have been described [15-17] . Interestingly, presence of antibodies against NF155 is significantly more frequent
[18]
in patients with primary progressive forms of MS than in those with relapsing disease .
Patients who develop antibodies against NF155 may ultimately present a different form of demyelinating
disease with both central and peripheral involvement. There are often signs of cerebellar, spinal root and
plexus involvement, optic nerve demyelination and high levels of protein in the spinal fluid in these cases.
Anti-NF155 antibodies may form a biomarker for a particular form of demyelinating neurological disease.
[9]
NF155 does not activate a complement . Therefore, at least in theory, patients with anti-NF155 antibodies
might respond well to therapies using ocrelizumab and rituximab. “Anti-NF155 demyelination” may be a
different disease with peculiar presentation and therapeutic management.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception of the study, as well as provided administrative, technical, and
material support: Goncalves MVM, Fragoso YD

Availability of data and materials
Not applicable.