Autoimmune Cerebellar Ataxia: Mechanisms and Therapeutic Strategies

Autoimmune cerebellar ataxia (ACA) represents an important and potentially treatable spectrum of immune-mediated disorders among sporadic ataxias. In recent years, the identification of an expanding repertoire of anti-cerebellar and paraneoplastic antibodies has refined disease classification, improved diagnostic workups, and provided new clues to pathogenic mechanisms. The concept of primary autoimmune cerebellar ataxia has also increased awareness of seronegative and non-paraneoplastic forms. Nevertheless, ACA remains under-recognized and clinically heterogeneous. Many patients lack specific biomarkers, present with overlapping phenotypes, or are diagnosed only after irreversible cerebellar injury has occurred. Limited pathological evidence suggests that immune-mediated injury, including T cell-associated Purkinje cell loss and antibody-related synaptic or neuronal dysfunction, may contribute to persistent disability. Early recognition and timely immunotherapy are therefore essential to preserve cerebellar function and quality of life.This Research Topic aims to bring together clinical, translational, and basic studies that advance our understanding of ACA from disease mechanisms to diagnosis and treatment. We particularly welcome work that clarifies how immune responses target the cerebellum, identifies robust biomarkers for early and accurate diagnosis, develops experimental systems that faithfully model ACA, and evaluates therapeutic strategies that can prevent irreversible neuronal loss. By integrating mechanistic studies, animal models, antibody discovery, pathological investigations, clinical cohorts, and treatment research, this collection seeks to promote a more precise framework for classifying ACA, stratifying patients, monitoring disease activity, and guiding individualized immunotherapy.We invite Original Research, Brief Research Reports, Reviews, Mini Reviews, Methods, Clinical Trial, and other relevant article types addressing, but not limited to, the following topics:1. Construction, validation, and application of cellular or animal models of ACA.2. Pathological and immunological studies of cerebellar injury, including Purkinje cell dysfunction or loss.3. Molecular, cellular, and circuit mechanisms underlying immune-mediated cerebellar dysfunction.4. Identification and validation of novel diagnostic markers, including anti-cerebellar antibodies, cerebrospinal fluid markers, imaging markers, and electrophysiological features.5. Clinical phenotyping, prognosis, and longitudinal natural-history studies of ACA.6. Large-scale, multicenter, or real-world clinical cohorts, including seropositive and seronegative ACA.7. Associations between ACA and tumors, systemic autoimmune diseases, infections, gluten-related disorders, or other immune triggers.8. Therapeutic studies of acute and maintenance immunotherapy, treatment timing, response predictors, rehabilitation, and long-term functional outcomes. Topic editors: Mange Liu, Hongzhi Guan, Marios Hadjivassiliou Source: https://www.frontiersin.org/research-topics/82410/autoimmune-cerebellar-ataxia-mechanisms-and-therapeutic-strategies