The functional impact of LGI1 autoantibodies on human CA3 pyramidal neurons

Autoantibodies against leucine-rich glioma inactivated 1 protein (LGI1 mAb) lead to limbic encephalitis characterized by seizures and memory deficits. While animal models provide insights into mechanisms of LGI1 mAb action, species-specific confirmation is lacking. In this study, we investigated the effects of patient-derived LGI1 mAb on human CA3 neurons using cultured ex vivo slices. Analysis of intrinsic properties and morphology indicated functional integrity of these neurons under incubation conditions. Human CA3 neurons received spontaneous excitatory currents with large amplitudes and frequencies, suggestive of "giant" AMPA currents. In slices exposed to LGI1 mAb, human CA3 neurons displayed increased neuronal spike frequency, mirroring effects observed with the Kv1.1 channel blocker DTX-K. This increase likely resulted from decreased Kv1.1 channel activity at the axonal initial segment, as indicated by alterations in action potential properties. A detailed analysis revealed differences between LGI1 mAb and DTX-K effects on action potential properties, suggesting distinct mechanisms of action and emphasizing the need for further exploration of downstream pathways. Our findings underscore the importance of species-specific confirmatory studies of disease mechanisms and highlight the potential of human hippocampal slice cultures as a translational model for investigation of disease mechanisms beyond epilepsy, including the effects of pharmacological compounds and autoantibodies. SignificanceThis study advances our understanding of how autoantibodies against the LGI1 protein, known to cause limbic encephalitis, impact human neurons. By using cultured slices of human hippocampus derived from epilepsys surgical resections, we were able to observe the direct effects of these autoantibodies on neurons, specifically CA3 pyramidal cells. Our findings reveal that the autoantibodies increase neuronal activity, similar to what is seen with potassium channel blockers and in animal models. This work emphasizes the importance of studying living tissue from the human brain to confirm disease mechanisms, and demonstrates the potential of using human brain slices as a model for exploring not only epilepsy but also other neurological diseases and drug effects.