ABSTRACT

High levels of antibodies against glutamic acid decarboxylase (GAD) are observed in patients with different neurological disorders, but cells producing these auto‐antibodies are largely unexplored. We detect circulating GAD‐reactive B cells in peripheral blood that readily differentiate into antibody‐producing cells. These cells are highly elevated in most patients with GAD‐antibody‐associated disorders (n=15) compared to controls (n=19). They mainly produce GAD65‐antibodies of the IgG1 and IgG4 subclasses and are as abundant as B cells reactive for common recall antigens. Bone marrow cells represent an additional source of GAD‐antibodies. The identification of GAD‐antibody‐producing cells has implications for the selection of cell‐specific biologics.

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