Neuronal surface antibody-mediated autoimmune encephalitis.
Neuronal surface antibody-mediated autoimmune encephalitis.
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DOI：
10.1055/s-0034-1390394
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发表时间：
2014-09
影响因子：
2.7
通讯作者：
Dalmau J
中科院分区：
文献类型：
--
作者：
Linnoila JJ;Rosenfeld MR;Dalmau J
在过去的几年里，许多自身免疫性脑炎已经被鉴定出来，它们具有特定的临床症状和相关的抗神经元表面抗原的抗体。有令人信服的证据表明，这些抗体中的许多是致病的，而且大多数脑磷脂对免疫疗法高度敏感。这些抗体介导的综合征中的一些临床谱系，特别是那些仅在少数患者中报道的，正在演变。其他的，如抗N-甲基-D-天冬氨酸(NMDA)受体脑炎，也有很好的特征。诊断包括识别特定的症状并识别患者脑脊液(CSF)和/或血清中的抗体。这些综合征与脑脊液、磁共振成像和脑电图的各种异常有关。治疗通常是多学科的，应侧重于中和抗体的影响并消除其来源。重叠的疾病已经被注意到，一些患者有不止一种神经自身免疫性疾病。在其他患者中，病毒感染，如单纯疱疹病毒性脑炎，会引发强大的抗神经元自身免疫反应。
In the past few years, many autoimmune encephalitides have been identified, with specific clinical syndromes and associated antibodies against neuronal surface antigens. There is compelling evidence that many of these antibodies are pathogenic and most of these encephalitides are highly responsive to immunotherapies. The clinical spectra of some of these antibody-mediated syndromes, especially those reported in only a few patients, are evolving. Others, such as anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, are well characterized. Diagnosis involves recognizing the specific syndromes and identifying the antibody in a patient’s cerebrospinal fluid (CSF) and/or serum. These syndromes are associated with variable abnormalities in CSF, magnetic resonance imaging, and electroencephalography. Treatment is often multidisciplinary and should be focused upon neutralizing the effects of antibodies and eliminating their source. Overlapping disorders have been noted, with some patients having more than one neurologic autoimmune disease. In other patients, viral infections such as herpes simplex virus encephalitis trigger robust antineuronal autoimmune responses.