Clinical and pathogenic significance of IgG, IgA, and IgM antibodies against the NMDA receptor.

Details

Serval ID
serval:BIB_EBFFE419C103
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical and pathogenic significance of IgG, IgA, and IgM antibodies against the NMDA receptor.
Journal
Neurology
Author(s)
Hara M., Martinez-Hernandez E., Ariño H., Armangué T., Spatola M., Petit-Pedrol M., Saiz A., Rosenfeld M.R., Graus F., Dalmau J.
ISSN
1526-632X (Electronic)
ISSN-L
0028-3878
Publication state
Published
Issued date
17/04/2018
Peer-reviewed
Oui
Volume
90
Number
16
Pages
e1386-e1394
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
To determine the frequency and clinical relevance of immunoglobulin (Ig)G, IgA, and IgM N-methyl-d-aspartate receptor (NMDAR) antibodies in several diseases, and whether the IgG antibodies occur in disorders other than anti-NMDAR encephalitis.
Evaluation of IgG, IgA, and IgM NMDAR antibodies in serum of 300 patients with anti-NMDAR encephalitis, stroke, dementia, schizophrenia, or seronegative autoimmune encephalitis. Antibodies and their effect on cultured neurons were examined with cell-based assays and brain and live neuronal immunostaining. Retrospective analysis of the clinical diagnoses of a cohort of 1,147 patients with IgG NMDAR antibodies identified since 2005.
Among the 300 patients studied, IgG NMDAR antibodies were only identified in those with anti-NMDAR encephalitis and all reacted with brain and live neurons. By cell-based assay, IgA or IgM antibodies were detected in 22 of 300 patients (7%) with different diseases, but only 10 (3%) reacted with brain and 7 (2%) with live neurons. In cultured neurons, IgG but not IgA or IgM antibodies caused a decrease of synaptic and extrasynaptic NMDAR. Among the cohort of 1,147 patients with IgG NMDAR antibodies, 1,015 (88.5%) had anti-NMDAR encephalitis, 45 (3.9%) a limited form of the disease, 41 (3.6%) autoimmune post-herpes simplex encephalitis, 37 (3.2%) overlapping syndromes (anti-NMDAR encephalitis and demyelinating disease), and 9 (0.8%) atypical encephalitic syndromes; none had schizophrenia.
IgG NMDAR antibodies are highly specific for anti-NMDAR encephalitis and cause a decrease of the levels of NMDAR. In contrast, IgA or IgM antibodies occur infrequently and nonspecifically in other diseases and do not alter the receptor levels.
Keywords
Animals, Anti-N-Methyl-D-Aspartate Receptor Encephalitis/blood, Anti-N-Methyl-D-Aspartate Receptor Encephalitis/cerebrospinal fluid, Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnostic imaging, Autoantibodies/blood, Autoantibodies/cerebrospinal fluid, Brain/metabolism, Brain/pathology, Cells, Cultured, Cohort Studies, Dementia/blood, Female, HEK293 Cells, Humans, Immunoglobulin A/blood, Immunoglobulin G/blood, Immunoglobulin M/blood, Male, Mice, Mutation/genetics, Neurons/metabolism, Positron-Emission Tomography, Rats, Receptors, N-Methyl-D-Aspartate/genetics, Receptors, N-Methyl-D-Aspartate/immunology, Schizophrenia/blood, Stroke/blood, Transfection
Pubmed
Web of science
Create date
22/03/2018 19:14
Last modification date
20/08/2019 16:14
Usage data