Abstract Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most prevalent type of encephalitis. Investigating the pathogenesis of anti-NMDAR encephalitis will enhance our understanding of this disease and play a central part in providing reasonable treatment for the patients. The pathogenesis is elucidated as follows: (1) the findings of the relationship between anti-NMDAR encephalitis and tumors; (2) further research on the relationship between anti-NMDAR encephalitis and tumors; (3) NMDAR epitopes and the autoimmunity of patients; (4) the interaction between antibody and NMDAR; (5) the pathogenesis of anti-NMDAR encephalitis without tumors. This review gives a brief introduction to the methodology and way of finding out the valuable clinical problems and making a clear and explicit explanation of them by exhibiting the process of discovering the disease, disclosing its relationship with tumors, and investigating its pathological and molecular mechanism. Current studies have demonstrated that anti-NMDAR encephalitis is an autoimmune disease of the nervous system that is closely associated with tumors, particularly ovarian teratoma.
About author:: [1] Gable MS, Sheriff H, Dalmau J, et al. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project [J].Clin Infect Diseases, 2012, 54(7): 899-904.[2] Titulaer MJ, Mccracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti- NMDA receptor encephalitis: an observational cohort study [J].Chin J Contemp Pediatr Lancet Neurol, 2013, 12(2): 157-165.[3] Vitaliani R, Mason W, Ances B, et al. Paraneoplastic encephalitis, psychiatric symptoms, and hypoventilation in ovarian teratoma[J].Ann Neurol, 2005, 58(4): 594-604.[4] Dalmau J, Tüzün E, Wu HY, et al. Paraneoplastic anti-Nmethyl- D-aspartate receptor encephalitis associated with ovarian teratoma[J].Ann Neurol, 2007, 61(1): 25-36.[5] Mangler M, Trebesch de Perez I, Teegen B, et al. Seroprevalence of anti-N-methyl-D-aspartate receptor antibodies in women with ovarian teratoma[J].J Neurol, 2013, 260(11): 2831-2835.[6] Seki M, Suzuki S, Iizuka T, et al. Neurological response to early removal of ovarian teratoma in anti-NMDAR encephalitis[J].J Neurol Neurosurg Psychiatry, 2008, 79(3): 324-326.[7] Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies [J].Lancet Neurol, 2008, 7(12): 1091-1098.[8] Tuzun E, Zhou L, Baehring JM, et al. Evidence for antibodymediated pathogenesis in anti-NMDAR encephalitis associated with ovarian teratoma [J].Acta Neuropathol, 2009, 118(6): 737- 743.[9] Dabner M, Mccluggage WG, Bundell C, et al. Ovarian teratoma associated with anti-N-methyl D-aspartate receptor encephalitis: a report of 5 cases documenting prominent intratumoral lymphoid infiltrates [J].Int J Gynecol Pathol, 2012, 31(5): 429-437.[10] Bien CG, Vincent A, Barnett MH, et al. Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis [J].Brain, 2012, 135(Pt 5): 1622-1638.[11] Irani SR, Bera K, Waters P, et al. N-methyl-D-aspartate antibody encephalitis: temporal progression of clinical and paraclinical observations in a predominantly non-paraneoplastic disorder of both sexes [J].Brain, 2010, 133(Pt 6): 1655-1667.[12] Camdessanche JP, Streichenberger N, Cavillon G, et al. Brain immunohistopathological study in a patient with anti-NMDAR encephalitis [J].Europ J Neurol, 2011, 18(6): 929-931.[13] Martinez-Hernandez E, Horvath J, Shiloh-Malawsky Y, et al. Analysis of complement and plasma cells in the brain of patients with anti-NMDAR encephalitis [J].Neurology, 2011, 77(6): 589- 593.[14] Hughes EG, Peng X, Gleichman AJ, et al. Cellular and synaptic mechanisms of anti-NMDA receptor encephalitis [J].J Neurosci, 2010, 30(17): 5866-5875.[15] Mikasova L, De R0ssi P, Bouchet D, et al. Disrupted surface cross-talk between NMDA and Ephrin-B2 receptors in anti- NMDA encephalitis [J].Brain, 2012, 135(Pt 5): 1606-1621.[16] Dulcey I, Cespedes MU, Ballesteros JL, et al. Necrotic mature ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis [J].Pathol Res Pract, 2012, 208(8): 497-500.[17] Peery HE, Day GS, Dunn S, et al. Anti-NMDA receptor encephalitis. The disorder, the diagnosis and the immunobiology[J].Autoimm Rev, 2012, 11(12): 863-872.
Cite this article:
LIU Meng-Jia,ZOU Li-Ping. Research advances in pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis[J]. CJCP, 2014, 16(6): 571-574.
LIU Meng-Jia,ZOU Li-Ping. Research advances in pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis[J]. CJCP, 2014, 16(6): 571-574.
Gable MS, Sheriff H, Dalmau J, et al. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project [J].Clin Infect Diseases, 2012, 54(7): 899-904.
[2]
Titulaer MJ, Mccracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti- NMDA receptor encephalitis: an observational cohort study [J].Chin J Contemp Pediatr Lancet Neurol, 2013, 12(2): 157-165.
[3]
Vitaliani R, Mason W, Ances B, et al. Paraneoplastic encephalitis, psychiatric symptoms, and hypoventilation in ovarian teratoma[J].Ann Neurol, 2005, 58(4): 594-604.
[4]
Dalmau J, Tüzün E, Wu HY, et al. Paraneoplastic anti-Nmethyl- D-aspartate receptor encephalitis associated with ovarian teratoma[J].Ann Neurol, 2007, 61(1): 25-36.
[5]
Mangler M, Trebesch de Perez I, Teegen B, et al. Seroprevalence of anti-N-methyl-D-aspartate receptor antibodies in women with ovarian teratoma[J].J Neurol, 2013, 260(11): 2831-2835.
[6]
Seki M, Suzuki S, Iizuka T, et al. Neurological response to early removal of ovarian teratoma in anti-NMDAR encephalitis[J].J Neurol Neurosurg Psychiatry, 2008, 79(3): 324-326.
[7]
Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies [J].Lancet Neurol, 2008, 7(12): 1091-1098.
[8]
Tuzun E, Zhou L, Baehring JM, et al. Evidence for antibodymediated pathogenesis in anti-NMDAR encephalitis associated with ovarian teratoma [J].Acta Neuropathol, 2009, 118(6): 737- 743.
[9]
Dabner M, Mccluggage WG, Bundell C, et al. Ovarian teratoma associated with anti-N-methyl D-aspartate receptor encephalitis: a report of 5 cases documenting prominent intratumoral lymphoid infiltrates [J].Int J Gynecol Pathol, 2012, 31(5): 429-437.
[10]
Bien CG, Vincent A, Barnett MH, et al. Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis [J].Brain, 2012, 135(Pt 5): 1622-1638.
[11]
Irani SR, Bera K, Waters P, et al. N-methyl-D-aspartate antibody encephalitis: temporal progression of clinical and paraclinical observations in a predominantly non-paraneoplastic disorder of both sexes [J].Brain, 2010, 133(Pt 6): 1655-1667.
[12]
Camdessanche JP, Streichenberger N, Cavillon G, et al. Brain immunohistopathological study in a patient with anti-NMDAR encephalitis [J].Europ J Neurol, 2011, 18(6): 929-931.
[13]
Martinez-Hernandez E, Horvath J, Shiloh-Malawsky Y, et al. Analysis of complement and plasma cells in the brain of patients with anti-NMDAR encephalitis [J].Neurology, 2011, 77(6): 589- 593.
[14]
Hughes EG, Peng X, Gleichman AJ, et al. Cellular and synaptic mechanisms of anti-NMDA receptor encephalitis [J].J Neurosci, 2010, 30(17): 5866-5875.
[15]
Mikasova L, De R0ssi P, Bouchet D, et al. Disrupted surface cross-talk between NMDA and Ephrin-B2 receptors in anti- NMDA encephalitis [J].Brain, 2012, 135(Pt 5): 1606-1621.
[16]
Dulcey I, Cespedes MU, Ballesteros JL, et al. Necrotic mature ovarian teratoma associated with anti-N-methyl-D-aspartate receptor encephalitis [J].Pathol Res Pract, 2012, 208(8): 497-500.
[17]
Peery HE, Day GS, Dunn S, et al. Anti-NMDA receptor encephalitis. The disorder, the diagnosis and the immunobiology[J].Autoimm Rev, 2012, 11(12): 863-872.
