The Role of Autoantibodies in Lambert‐Eaton Myasthenic Syndromeaa

The Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of neuromuscular transmission that causes fatigable muscle weakness, loss of tendon reflexes, and autonomic dysfunction.1–3 LEMS antibodies bind to and induce a downregulation of voltage-gated channels (VGCCs),4,5 resulting in a reduction in the nerve-evoked, Ca2+-dependent release of acetylcholine from motor nerve terminals. Approximately 60% of patients have an associated small cell lung carcinoma (SCLC),6 a tumor that is thought to be neuroendocrine in origin. This strong association with cancer makes LEMS a member of the group of paraneoplastic disorders. SCLC cells have been shown to express functional VGCCs,7,8 and preincubation in LEMS sera or IgG reduces the K+-stimulated 45Ca2+ flux into these cells.8–10