Autoimmunity in psychotic disorders. Where we stand, challenges and opportunities

Publication date: Available online 16 July 2019Source: Autoimmunity ReviewsAuthor(s): Marina Mané-Damas, Carolin Hoffmann, Shenghua Zong, Amanda Tan, Peter C. Molenaar, Mario Losen, Pilar Martinez-MartínezAbstractPsychotic disorders are debilitating mental illnesses associated with abnormalities in various neurotransmitter systems. The development of disease-modifing therapies has been hampered by the mostly unknown etiologies and pathophysiologies.Autoantibodies against several neuronal antigens are responsible for autoimmune encephalitis. These autoantibodies disrupt neurotransmission within the brain, resulting in a wide range of psychiatric and neurologic manifestations, including psychosis. The overlap of symptoms of autoimmune encephalitis with psychotic disorders raised the question as to whether autoantibodies against a number of receptors, ion channel and associated proteins could ultimately be responsible for some forms of psychosis. Here we review our current knowledge, on antibody mediated autoimmunity in psychotic disorders, the different diagnostic methods and their limitations, as well as varying therapeutic approaches targeting the immune system.
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research

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Abstract Evaluation of Seizure Treatment in Anti-LGI1, Anti-NMDAR, and Anti-GABABR Encephalitis de Bruijn MAAM, van Sonderen A, van Coevorden-Hameete MH, Bastiaansen AEM, Schreurs MWJ, Rouhl RPW, van Donselaar CA, Majoie MHJM, Neuteboom RF, Sillevis Smitt PAE, Thijs RD, Titulaer MJ. Neurology. 2019;92(19): e2185-e2196. doi:10.1212/WNL.0000000000007475. Epub April 12, 2019. PMID: 30979857 OBJECTIVE: This nationwide cohort study evaluates seizure responses to immunotherapy and antiepileptic drugs (AEDs) in patients with anti-leucine-rich glioma-inactivated 1 (LGI1), anti-NMDA receptor (NMDAR), and anti-gamma-aminobu...
Source: Epilepsy Curr - Category: Neurology Authors: Tags: Epilepsy Curr Source Type: research
Abstract Immune-mediated inflammation of the brain has been recognized for more than 50 years, although the initial descriptions were mainly thought to be secondary to an underlying neoplasm. Some of these paraneoplastic encephalitides express serum antibodies, but these were not thought to be pathogenic but instead have a T-cell-mediated pathophysiology. Over the last two decades, several pathogenic antibodies against neuronal surface antigens have been described in autoimmune encephalitis, which are amenable to immunotherapy. Several of these antibodies are directed against glutamate receptors (GluRs). NMDA...
Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
This article reviews the recent advances on the antibody detection, neuroimaging and treatment of autoimmune encephalitis. AbstractNon ‐infectious encephalitis has been a recognized entity for many years; however, its pathophysiology was not fully understood. Patients (usually women) presented with acute behavioral changes and were admitted to mental hospitals, without a correct diagnosis. With the new advances on antibody detect ion, the non‐infectious encephalitis panorama has been changing. Immune‐mediated diseases of the central nervous system encompass a variety of disorders, including the classic paraneoplastic...
Source: Clinical and Experimental Neuroimmunology - Category: Neurology Authors: Tags: Review Article Source Type: research
Conclusions We show a clear association between ICI use and increased diagnosis of Ma2-PNS. Physicians need to be aware that ICIs can trigger Ma2-PNS because clinical presentation can be challenging.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: All Immunology, Autoimmune diseases, All Oncology, Paraneoplastic syndrome Article Source Type: research
Authors: Joubert B, Dalmau J Abstract Autoimmune encephalitides are autoimmune neurological disorders characterized by rapidly progressive central nervous system symptoms associated with specific auto-antibodies targeting neuronal cell-surface proteins. The clinical features of encephalitis are frequently preceded by symptoms suggesting an infectious process, and specific pathogens have been detected at the early phase of the disease in some patients, suggesting that it can be triggered by infections. Moreover, recent data have shown an association with specific HLA haplotypes, suggesting a genetic susceptibility t...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
Semin Neurol 2019; 39: 312-321 DOI: 10.1055/s-0039-1687838Despite recent advances in diagnostic and therapeutic modalities for infectious and autoimmune encephalitis, the management of patients with suspected or confirmed encephalitis poses a great challenge to physicians. Neuroimaging, including magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning, can play a crucial role in substantiating the diagnosis of encephalitis and eliminating clinical mimics of encephalitis from consideration. Moreover, characteristic neuroimaging patterns can aid in defining specific infectious and autoimmune etiologi...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
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Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
Publication date: Available online 17 July 2019Source: The Lancet NeurologyAuthor(s): Josep Dalmau, Thais Armangué, Jesús Planagumà, Marija Radosevic, Francesco Mannara, Frank Leypoldt, Christian Geis, Eric Lancaster, Maarten J Titulaer, Myrna R Rosenfeld, Francesc GrausSummaryThe identification of anti-NMDA receptor (NMDAR) encephalitis about 12 years ago made it possible to recognise that some patients with rapidly progressive psychiatric symptoms or cognitive impairment, seizures, abnormal movements, or coma of unknown cause, had an autoimmune disease. In this disease, autoantibodies serve as a diag...
Source: The Lancet Neurology - Category: Neurology Source Type: research
Conclusions: Daclizumab was the only recently approved monoclonal antibody associated with DRESS syndrome as such. Limitations in the diagnostic reliability of DRESS syndrome as a clinical entity and the lack of negative clinical trial reporting suggest enhanced vigilance on the part of clinicians and regulators may be warranted. PMID: 31308976 [PubMed]
Source: Autoimmune Diseases - Category: Allergy & Immunology Tags: Autoimmune Dis Source Type: research
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