Six autoantibodies associated with autoimmune encephalitis are not detectable in the cerebrospinal fluid of suicide attempters

Abstract The autoimmune encephalitis (AE) syndromes have been characterised by the detection of autoantibodies in serum and/or cerebrospinal fluid which target the extracellular domains of specific neuroglial antigens. The clinical syndromes have phenotypes which are often highly characteristic of their associated antigen-specific autoantibody. For example, the constellation of psychiatric features and the multi-faceted movement disorder observed in patients with NMDAR antibodies are highly distinctive, as are the faciobrachial dystonic seizures observed in close association with LGI1 antibodies. These typically tight correlations may be conferred by the presence of autoantibodies which can directly access and modulate their antigens in vivo. AE remains an under-recognised clinical syndrome but one where early and accurate detection is critical as prompt initiation of immunotherapy is closely associated with improved outcomes. In this review of a rapidly emerging field, we outline molecular observations with translational value. We focus on contemporary methodologies of autoantibody detection, the evolution and distinctive nature of the clinical phenotypes, generalisable therapeutic paradigms, and finally discuss the likely mechanisms of autoimmunity in these patients which may inform future precision therapies.

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Insulin and glucagon in plasma and cerebrospinal fluid in suicide attempters and healthy controls

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2017.03.019 ◽

2017 ◽

Vol 81 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Marie Bendix ◽

Kerstin Uvnäs-Moberg ◽

Maria Petersson ◽

Viktor Kaldo ◽

Marie Åsberg ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Healthy Controls ◽

Suicide Attempters

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Transthyretin in cerebrospinal fluid from suicide attempters

Journal of Affective Disorders ◽

10.1016/j.jad.2007.11.007 ◽

2008 ◽

Vol 109 (1-2) ◽

pp. 205-208 ◽

Cited By ~ 3

Author(s):

Kristofer Schultz ◽

Lil Träskman-Bendz ◽

Åsa Petersén

Keyword(s):

Cerebrospinal Fluid ◽

Suicide Attempters

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Cerebrospinal Fluid Findings in Patients With Autoimmune Encephalitis—A Systematic Analysis

Frontiers in Neurology ◽

10.3389/fneur.2019.00804 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 25

Author(s):

Tetyana Blinder ◽

Jan Lewerenz

Keyword(s):

Cerebrospinal Fluid ◽

Autoimmune Encephalitis ◽

Systematic Analysis

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Low vascular endothelial growth factor and interleukin-8 in cerebrospinal fluid of suicide attempters

Translational Psychiatry ◽

10.1038/tp.2012.123 ◽

2012 ◽

Vol 2 (11) ◽

pp. e196-e196 ◽

Cited By ~ 45

Author(s):

J Isung ◽

S Aeinehband ◽

F Mobarrez ◽

B Mårtensson ◽

P Nordström ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Cerebrospinal Fluid ◽

Growth Factor ◽

Interleukin 8 ◽

Vascular Endothelial ◽

Suicide Attempters ◽

Endothelial Growth Factor

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Autoimmune encephalitis: differences of clinical features between antibody-positive and antibody-negative conditions

10.21203/rs.2.9140/v2 ◽

2019 ◽

Author(s):

Tingting Li ◽

Zhihua Si ◽

Lu Lu ◽

Aihua Wang

Keyword(s):

Cerebrospinal Fluid ◽

Clinical Features ◽

Neurological Diseases ◽

Combined Therapy ◽

Clinical Manifestations ◽

Autoimmune Encephalitis ◽

Negative Group ◽

Positive Group ◽

Rigorous Treatment ◽

Wbc Count

Abstract Autoimmune encephalitis is a kind of immune disease with a higher incidence while classification and analysis based upon different states of antibodies are scarcely reported. We intend to compare the clinical features of autoimmune encephalitis between antibody-positive and antibody-negative, with a goal of contributing to early diagnosis and facilitate clinical treatment decisions, especially concerning antibody negative cases. A total of 38 patients with autoimmune encephalitis were enrolled and patients with infections, hereditary, metabolic or toxic neurological diseases were excluded. Based on the serum and cerebrospinal fluid (CSF) antibody results, all patients were divided into antibody-positive group and antibody-negative group. The clinical manifestations of the two groups were compared in detail. The number of antibody-positive group with immuno-related injury (p=0.012), number of combined symptoms (p=0.027) and abnormal secretion of exocrine glands (p=0.023) were higher than antibody-negative group; patients with psychiatry department treatment history exceeded antibody-negative group (p=0.014) and patients with epileptic of antibody-positive group was less than that of antibody-negative group (p=0.028). Majority of patients in antibody-positive group displayed cerebrospinal fluid (CSF) pressure and white blood cell (WBC) count increased while that in a small number of antibody-negative group (p = 0.043, p=0.045). Baseline mRS scores of antibody-positive group were higher than negative group at admission (p=0.049), and mRS in both groups were significantly lower at discharge than admission (p=0.010, p =0.011). Compared with antibody-negative group, the combined therapy in antibody-positive group was more common (p=0.025).Although antibody-positive patients may have more serious conditions,but the data suggest that in spite of some differences between antibody positive and negative patients, they are quite similar and perhaps should be subjected to the same rigorous treatment or management protocols. Immunotherapy might play an important role in relieving symptoms.

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Autoimmune encephalitis: differences of clinical features between antibody-positive and antibody-negative conditions

10.21203/rs.2.9140/v1 ◽

2019 ◽

Author(s):

Tingting Li ◽

Zhihua Si ◽

Lu Lu ◽

Aihua Wang

Keyword(s):

Cerebrospinal Fluid ◽

Clinical Features ◽

Neurological Diseases ◽

Combined Therapy ◽

Clinical Manifestations ◽

Autoimmune Encephalitis ◽

Negative Group ◽

Positive Group ◽

Rigorous Treatment ◽

Wbc Count

Abstract Autoimmune encephalitis is a kind of immune disease with a higher incidence while classification and analysis based upon different states of antibodies are scarcely reported. We intend to compare the clinical features of autoimmune encephalitis between antibody-positive and antibody-negative, with a goal of contributing to early diagnosis and facilitate clinical treatment decisions, especially concerning antibody negative cases. A total of 38 patients with autoimmune encephalitis were enrolled and patients with infections, hereditary, metabolic or toxic neurological diseases were excluded. Based on the serum and cerebrospinal fluid (CSF) antibody results, all patients were divided into antibody-positive group and antibody-negative group. The clinical manifestations of the two groups were compared in detail. The number of antibody-positive group with immuno-related injury (p=0.012), number of combined symptoms (p=0.027) and abnormal secretion of exocrine glands (p=0.023) were higher than antibody-negative group; patients with psychiatry department treatment history exceeded antibody-negative group (p=0.014) and patients with epileptic of antibody-positive group was less than that of antibody-negative group (p=0.028). Majority of patients in antibody-positive group displayed cerebrospinal fluid (CSF) pressure and white blood cell (WBC) count increased while that in a small number of antibody-negative group (p = 0.043, p=0.045). Baseline mRS scores of antibody-positive group were higher than negative group at admission (p=0.049), and mRS in both groups were significantly lower at discharge than admission (p=0.010, p =0.011). Compared with antibody-negative group, the combined therapy in antibody-positive group was more common (p=0.025).Although antibody-positive patients may have more serious conditions,but the data suggest that in spite of some differences between antibody positive and negative patients, they are quite similar and perhaps should be subjected to the same rigorous treatment or management protocols. Immunotherapy might play an important role in relieving symptoms.

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