Anti-cN-1A (NT5c1A) antibodies are a specific biomarker crucial in the diagnosis and understanding of Inclusion Body Myositis (IBM), a progressive and chronic inflammatory muscle disorder. These antibodies target the protein 5'-nucleotidase 1A (NT5c1A), which plays a role in purine metabolism. The presence of Anti-cN-1A (NT5c1A) antibodies is increasingly recognized as a distinctive serological marker for IBM, distinguishing it from other inflammatory myopathies. IBM is characterized by progressive muscle weakness and atrophy, primarily affecting the quadriceps and forearm muscles. Unlike other myositis forms, IBM is generally resistant to conventional immunosuppressive therapies, making its early and accurate diagnosis through biomarkers like Anti-cN-1A (NT5c1A) particularly important for patient management.

Anti-Contactin-associated protein-like 2 (CASPR2) antibodies, including both IgG and IgA classes, are autoantibodies targeting the CASPR2 protein, a component of the voltage-gated potassium channel complex located in the nervous system. The presence of these antibodies is associated with a spectrum of neurological conditions, often termed CASPR2-antibody associated syndromes, which include neuromyotonia (also known as Isaac's syndrome), Morvan syndrome, and autoimmune forms of limbic encephalitis.

Patients with anti-CASPR2 antibodies can present with various symptoms depending on the affected region of the nervous system. In neuromyotonia, symptoms may include muscle twitching, cramps, and stiffness, whereas limbic encephalitis is characterized by memory loss, confusion, seizures, and sometimes psychiatric symptoms. Morvan syndrome is distinguished by a combination of neuromyotonia and encephalitis symptoms, along with autonomic dysfunction like sleep disturbances, sweating, and cardiac irregularities.

Anti-Contactin-associated protein-like 2 (CASPR2) antibodies of the IgM class are less commonly reported compared to their IgG counterparts but represent an important aspect of the immune response in certain autoimmune neurological disorders. CASPR2 is a cell adhesion molecule that plays a significant role in the proper functioning of the nervous system, particularly in the juxtaparanodal regions of myelinated axons, where it helps to cluster potassium channels. These potassium channels are crucial for maintaining the electrical excitability of nerve cells. When anti-CASPR2 IgM antibodies target this protein, they can disrupt normal neuronal function, leading to a range of clinical manifestations.

Anti-CV2 antibodies, encompassing both IgG and IgA immunoglobulin classes, target a neuronal protein known as CRMP-5 (Collapsin Response Mediator Protein 5). These antibodies are typically associated with paraneoplastic neurological syndromes (PNS), a group of disorders that arise from the immune system's response to certain cancers. The presence of anti-CV2 antibodies can lead to a variety of neurological manifestations, ranging from cerebellar ataxia, limbic encephalitis, to peripheral neuropathies, and less frequently, myelopathies.

Anti CV2 antibodies are a group of antibodies that react with a 66 kd brain protein belonging to the family of CRMP proteins. The manifestations associated with anti CV2 antibodies include cerebellar degeneration, uveitis, and peripheral neuropathy, and mixed axonal and demyelinating peripheral neuropathy.

The anti-dsDNA test identifies the presence of these autoantibodies in the blood.

The test for anti-dsDNA, along with other autoantibody tests, may be used to help establish a diagnosis of lupus and distinguish it from other autoimmune disorders.

The anti-double-stranded DNA antibody (anti-dsDNA) is a specific type of ANA antibody found in about 30% of people with systemic lupus. Less than 1% of healthy individuals have this antibody, making it helpful in confirming a diagnosis of systemic lupus. The absence of anti-dsDNA, however, does not exclude a diagnosis of lupus. 

The presence of anti-dsDNA antibodies often suggests more serious lupus, such as lupus nephritis (kidney lupus). When the disease is active, especially in the kidneys, high amounts of anti-DNA antibodies are usually present. However, the anti-dsDNA test cannot be used to monitor lupus activity, because anti-dsDNA can be present without any clinical activity. Three tests are currently used to detect anti-dsDNA antibodies, namely enzyme-linked immunosorbent assay (ELISA), the Crithidia luciliae immunofluorescence test, and a test called radioimmunoassay.

Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).

Anti-Deamidated Gliadin IgA (DGP IgA) is a key marker for detecting celiac disease by measuring IgA antibodies against gluten fragments (deamidated gliadin peptides). It’s especially useful for identifying early-stage disease or confirming unclear results from other tests like tTG IgA. Elevated DGP IgA indicates an immune response to gluten, suggesting potential intestinal damage. If levels are high, further testing, such as an intestinal biopsy, may be needed to confirm the diagnosis and guide treatment with a gluten-free diet.

Anti-Deamidated Gliadin IgG (DGP IgG) is a key marker for detecting celiac disease and gluten sensitivity, especially in individuals with IgA deficiency or unclear test results. Elevated DGP IgG levels suggest an immune reaction to gluten, indicating possible celiac disease or non-celiac gluten sensitivity. It’s a reliable alternative when standard IgA-based tests are inconclusive. If your DGP IgG is high, consult your healthcare provider for further evaluation, such as additional antibody tests or a biopsy, to confirm the diagnosis and determine if a gluten-free diet is needed.

The anti-dsDNA test identifies the presence of these autoantibodies in the blood.

The test for anti-dsDNA, along with other autoantibody tests, may be used to help establish a diagnosis of lupus and distinguish it from other autoimmune disorders.

The anti-double-stranded DNA antibody (anti-dsDNA) is a specific type of ANA antibody found in about 30% of people with systemic lupus. Less than 1% of healthy individuals have this antibody, making it helpful in confirming a diagnosis of systemic lupus. The absence of anti-dsDNA, however, does not exclude a diagnosis of lupus. 

The presence of anti-dsDNA antibodies often suggests more serious lupus, such as lupus nephritis (kidney lupus). When the disease is active, especially in the kidneys, high amounts of anti-DNA antibodies are usually present. However, the anti-dsDNA test cannot be used to monitor lupus activity, because anti-dsDNA can be present without any clinical activity. Three tests are currently used to detect anti-dsDNA antibodies, namely enzyme-linked immunosorbent assay (ELISA), the Crithidia luciliae immunofluorescence test, and a test called radioimmunoassay.

Low to moderate levels of the autoantibody may be seen with other autoimmune disorders, such as Sjögren syndrome and mixed connective tissue disease (MCTD).

Anti-DNase B is a blood test to look for antibodies to a substance (protein) produced by group A streptococcus. This is the bacteria that cause strep throat.

Negative anti-DNase B and ASO tests or very low titers means that it is unlikely you had a recent strep infection. This is especially true if a sample taken 10 to 14 days later is also negative. Your signs and symptoms are likely due to a cause other than a recent strep infection.

What is Anti-Dopamine Receptor 1 (IgG + IgA)?

The Anti-Dopamine Receptor 1 (D1R) antibodies test measures IgG and IgA antibodies against dopamine receptor 1 (D1R), a key receptor in the brain involved in cognitive function, movement, and motivation. The presence of these antibodies may indicate immune system activity against dopamine receptors, potentially affecting neurological function.

A mildly elevated result for Anti-Dopamine Receptor 1 (IgG + IgA) on the Neural Zoomer Plus panel by Vibrant America suggests a low to moderate immune response targeting dopamine receptor 1 (D1R) in the brain. While not as concerning as a highly elevated result, it may still indicate underlying neuroinflammation, immune dysregulation, or an early-stage autoimmune response.

Possible Implications of a Mild Elevation

1. Early or Low-Grade Autoimmune Activity

   • A mild elevation may suggest the immune system is beginning to recognize dopamine receptors as targets, but the response is not yet severe.
   • Could be associated with mild neuroinflammation or early stages of conditions like autoimmune encephalitis or PANS/PANDAS (in children).

2. Transient Immune Activation

   • A temporary immune response due to a past infection, recent illness, or environmental trigger (e.g., viral infections, toxins, or stress).
   • If IgA is elevated, it may indicate a more recent immune activation, while IgG elevation suggests a longer-term or past immune response.

3. Subclinical Neurological Impact

   • While not necessarily causing overt neurological symptoms, a mild elevation could be linked to brain fog, mild mood changes, anxiety, or subtle cognitive impairments.
   • If symptoms are present, monitoring for changes over time may be beneficial.

4. Blood-Brain Barrier Permeability ("Leaky Brain")

   • Elevated IgA and IgG antibodies against D1R could indicate a compromised blood-brain barrier, allowing immune cells to interact with brain receptors more than usual.
   • May be associated with gut permeability (leaky gut), chronic inflammation, or systemic autoimmunity.

Next Steps for a Mild Elevation

• Retesting in a few months can help determine if the elevation is persistent or transient.
• Assess symptoms – If there are neurological or cognitive issues, further evaluation may be needed.
• Investigate underlying inflammation – Check for infections, gut health issues, or other autoimmune markers.
• Support brain health – Anti-inflammatory approaches (diet, lifestyle changes, and supplements like omega-3s, curcumin, and antioxidants) may help regulate immune activity.

What Is Anti-Dopamine Receptor 2 (IgG + IgA)?

The Anti-Dopamine Receptor 2 (DRD2) antibodies test measures immune reactivity to dopamine receptor 2 (DRD2) in the brain. Dopamine receptors play a crucial role in neurotransmission, regulating movement, cognition, mood, and behavior. The presence of IgG and IgA antibodies against DRD2 may indicate an autoimmune reaction targeting these receptors.

A mildly elevated Anti-Dopamine Receptor 2 (IgG + IgA) result on the Neural Zoomer Plus panel by Vibrant America may indicate low-grade neuroimmune activation without necessarily pointing to an active or severe autoimmune condition. This can suggest:

Possible Implications of a Mild Elevation:

1. Early or Low-Grade Neuroinflammation:

   • A mild immune response against dopamine receptor 2 (DRD2) may indicate early signs of neuroinflammation, which can be influenced by infections, gut health, or environmental factors.

2. Past Exposure or Immune Memory:

   • Mild elevations, particularly in IgG, might reflect past immune activity rather than an ongoing aggressive autoimmune attack. It may suggest a resolved or controlled response rather than active disease progression.

3. Gut-Brain Axis Imbalance:

   • Since IgA antibodies are primarily associated with mucosal immunity, a mild elevation in IgA could indicate a gut-brain connection, such as intestinal permeability (leaky gut) or dysbiosis triggering low-level immune cross-reactivity with dopamine receptors.

4. Molecular Mimicry & Post-Infectious Effects:

   • A mild elevation could result from a previous infection or immune challenge (e.g., streptococcal infections, viruses, or gut pathogens) that triggered an immune response with mild cross-reactivity against DRD2.
   • This is often seen in PANDAS/PANS, post-viral syndromes, or Lyme-associated neuroinflammation.

5. Subclinical or Early Autoimmune Activity:

   • Mildly elevated Anti-DRD2 antibodies might be an early marker of subclinical autoimmunity affecting the dopaminergic system, possibly increasing the risk of future mood, cognitive, or movement-related issues if other inflammatory markers are present.

6. Neurological & Psychiatric Symptoms Without Diagnosis:

   • Individuals with mild elevations may experience mild cognitive, behavioral, or mood-related symptoms (e.g., brain fog, anxiety, fatigue, subtle movement irregularities) without a clear clinical diagnosis.
   • If symptoms are present, addressing inflammation and immune regulation may be beneficial.

What Should You Do If Your Anti-DRD2 Result Is Mildly Elevated?

• Monitor symptoms: Pay attention to neurological, cognitive, or psychiatric symptoms that may correlate with dopamine dysregulation.
• Assess gut health: Address dysbiosis, food sensitivities, and leaky gut to reduce immune cross-reactivity.
• Check for infections: Rule out chronic infections (e.g., Strep, EBV, Lyme, viral triggers) that may be driving mild immune activation.
• Reduce inflammation: Anti-inflammatory and neuroprotective strategies (omega-3s, antioxidants, polyphenols, low-toxin diet) may help regulate immune responses.
• Consider retesting: If symptoms persist or worsen, a follow-up test in 3-6 months can help track immune activity.

Bottom Line

A mildly elevated Anti-Dopamine Receptor 2 (IgG + IgA) result does not necessarily indicate disease, but it suggests low-level immune reactivity that could be linked to past infections, gut-brain axis issues, or early neuroimmune dysregulation. Evaluating other biomarkers, symptoms, and potential triggers can provide more context for managing overall neurological and immune health.