Immunopathogenesis of Stiff-Person Spectrum Disorders

  • Pichet Termsarasab
  • Thananan Thammongkolchai
  • Bashar Katirji


Stiff-person spectrum disorders (SPSD) are autoimmune disorders. Glutamic acid decarboxylase (GAD) is an intracellular presynaptic antigen which belongs to a unique category, different from onconeuronal antigens and postsynaptic proteins. However, the pathophysiology and the roles of anti-GAD65 antibodies remain unclear. Controversies regarding anti-GAD65 antibodies include whether the pathophysiology is mainly antibody- or T-cell-mediated and whether the antibodies have direct pathogenic role or just represent a biomarker. Current knowledge gaps also include interaction between anti-GAD65 antibodies and intracellular GAD65 antigen, as well as immunopathogenesis of other less common antibodies associated with SPSD.


Stiff-person syndrome Anti-GAD Pathogenesis Immunology Pathophysiology Immunopathogenesis Autoimmunity 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Pichet Termsarasab
    • 1
  • Thananan Thammongkolchai
    • 1
  • Bashar Katirji
    • 2
  1. 1.Division of NeurologyFaculty of Medicine Ramathibodi Hospital, Mahidol UniversityBangkokThailand
  2. 2.Department of NeurologyUniversity Hospitals Cleveland Medical Center, Case Western Reserve UniversityClevelandUSA

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