Neuroimmunology of the Paraneoplastic Neurological Degenerations

The paraneoplastic neurological degenerations (PNDs) are remarkable examples of naturally occurring tumor immunity in humans. In PND patients, common tumors such as breast, ovarian and lung tumors express proteins normally made exclusively in the brain, eliciting an immune response that successfully suppresses growth of the tumor. This successful anti-tumor response would be expected to go clinically unnoticed by the patient, but the immune cells mediating the response somehow cross into the brain, resulting in an autoimmune attack on neurons and neurological symptoms. Pieces of the mystery of this tumor immune response and neuronal autoimmunity have been assembled, but much more needs to be learned.