Hyper-N-glycosylated autoantigen-mediated CNS tropism. (A) PCNSL cells are derived from germinal center exit B cells that preferentially express BCR using the IGVH-4-34 genes that are known to produce antibodies with increased autoreactivity. Besides uniform activation of the BCR with CD79B mutations, PCNSL cells exhibit frequent cooccurring MYD88L265P and infrequent CARD11 mutations, both known genetic alterations associated with tolerance failure and survival of autoantigen recognizing B cells (lower). In this issue of Blood, Thurner et al identify that PCNSL patients exhibit a hyper-N-glycosylated form of SAMD14 and neurabin-1 with high expression in the CNS tissue (upper). (B) Thurner et al discovered that the BCR of the PCNSL cells recognize the hyper-N-glycosylated forms of SAMD14 and neurabin-1, providing an attractive explanation that they have a canonical role in CNS tropism of this disease. (C) Concept of BCR-directed targeted therapy. A toxin is bound to the epitope of neurabin-1 that then bound specifically the tumor cells.

Hyper-N-glycosylated autoantigen-mediated CNS tropism. (A) PCNSL cells are derived from germinal center exit B cells that preferentially express BCR using the IGVH-4-34 genes that are known to produce antibodies with increased autoreactivity. Besides uniform activation of the BCR with CD79B mutations, PCNSL cells exhibit frequent cooccurring MYD88L265P and infrequent CARD11 mutations, both known genetic alterations associated with tolerance failure and survival of autoantigen recognizing B cells (lower). In this issue of Blood, Thurner et al identify that PCNSL patients exhibit a hyper-N-glycosylated form of SAMD14 and neurabin-1 with high expression in the CNS tissue (upper). (B) Thurner et al discovered that the BCR of the PCNSL cells recognize the hyper-N-glycosylated forms of SAMD14 and neurabin-1, providing an attractive explanation that they have a canonical role in CNS tropism of this disease. (C) Concept of BCR-directed targeted therapy. A toxin is bound to the epitope of neurabin-1 that then bound specifically the tumor cells.

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