Blood and CSF findings of cellular immunity in anti-NMDAR encephalitis

被引:2
作者
Wang, Jierui [1 ]
Luo, Limei [2 ]
Meng, Zirui [2 ]
Ren, Yan [2 ]
Tang, Meng [2 ]
Huang, Zhuochun [2 ]
Yang, Bin [2 ]
Niu, Qian [2 ]
Zhou, Dong [1 ]
Wang, Minjin [1 ,2 ]
Li, Jinmei [1 ]
机构
[1] Sichuan Univ, Dept Neurol, West China Hosp, Chengdu, Sichuan, Peoples R China
[2] Sichuan Univ, Dept Lab Med, West China Hosp, Chengdu, Sichuan, Peoples R China
关键词
anti-NMDA receptor encephalitis; Viral encephalitis; Immune cell analysis; Flow cytometer; RECEPTOR ENCEPHALITIS; T-CELLS; DIAGNOSIS; VIRUS; INFILTRATION; LYMPHOCYTE; CONSENSUS; SEVERITY; BRAIN; CNS;
D O I
10.1016/j.intimp.2024.111743
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objectives: To investigate the immunopathogenic mechanisms of anti-N-methyl-D-aspartate receptor encephalitis (NMDAR-E) by characterizing the changes of immune cells in both peripheral blood (PB) and cerebrospinal fluid (CSF) of patients with NMDAR-E. Methods: Cytology and flow cytometry were used to explore and compare different immunological parameters in PB and CSF of patients with NMDAR-E, viral encephalitis (VE) and healthy volunteers. Moreover, different models were established to assess the possibility of identifying NMDAR-E patients based on PB and CSF parameters. Results: The neutrophil counts and monocyte-to-lymphocyte ratios (MLR) in PB are higher in NMDAR-E patients than in both VEs and controls (P < 0.001, respectively), while the percentages of CD3 + T, CD4 + T lymphocytes, and the leukocytes count in CSF were lower in NMDAR-Es than in VEs (P < 0.01, respectively). The higher percentages of CD8 + T cells in blood and CSF were both correlated with more severe NMDAR-E (P < 0.05, respectively). The poor neurological status group had significantly higher PB leukocytes but lower CSF leukocyte count (P < 0.05). Longitudinal observations in patients with NMDAR-E showed a decreasing trend of leukocyte count, neutrophils count, neutrophil-to-monocyte ratios (NMR), and neutrophil-to-lymphocyte ratios (NLR) with the gradual recovery of neurological function. Conclusions: The expression patterns of T lymphocyte subsets were different in patients with NMDAR-E and viral encephalitis. The changing trends of leukocyte and lymphocyte populations in peripheral blood and cerebrospinal fluid may provide clues for the diagnosis of different types of encephalitides, including NMDARE, and can be used as immunological markers to assess and predict the prognosis.
引用
收藏
页数:9
相关论文
共 49 条
[1]   Cervical lymph nodes and ovarian teratomas as germinal centres in NMDA receptor-antibody encephalitis [J].
Al-Diwani, Adam ;
Theorell, Jakob ;
Damato, Valentina ;
Bull, Joshua ;
McGlashan, Nicholas ;
Green, Edward ;
Kienzler, Anne-Kathrin ;
Harrison, Ruby ;
Hassanali, Tasneem ;
Campo, Leticia ;
Browne, Molly ;
Easton, Alistair ;
Majd, Hooman Soleymani ;
Tenaka, Keiko ;
Iorio, Raffaele ;
Dale, Russell C. ;
Harrison, Paul ;
Geddes, John ;
Quested, Digby ;
Sharp, David ;
Lee, Soon-Tae ;
Nauen, David W. ;
Makuch, Mateusz ;
Lennox, Belinda ;
Fowler, Darren ;
Sheerin, Fintan ;
Waters, Patrick ;
Leite, M. Isabel ;
Handel, Adam E. ;
Irani, Sarosh R. .
BRAIN, 2022, 145 (08) :2742-2754
[2]   Real-world experience of assessing antibodies against the N-methyl-D-aspartate receptor (NMDAR-IgG) in psychiatric patients. A retrospective single-centre study [J].
Arino, Helena ;
Coutinho, Ester ;
Pollak, Thomas A. ;
Stewart, Robert .
BRAIN BEHAVIOR AND IMMUNITY, 2021, 98 :330-336
[3]   Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis: a prospective observational study and retrospective analysis [J].
Armangue, Thais ;
Spatola, Marianna ;
Vlagea, Alexandru ;
Mattozzi, Simone ;
Carceles-Cordon, Marc ;
Martinez-Heras, Eloy ;
Llufriu, Sara ;
Muchart, Jordi ;
Elena Erro, Maria ;
Abraira, Laura ;
Moris, German ;
Monros-Gimenez, Luis ;
Corral-Corral, Inigo ;
Montejo, Carmen ;
Toledo, Manuel ;
Bataller, Luis ;
Secondi, Gabriela ;
Arino, Helena ;
Martinez-Hernandez, Eugenia ;
Juan, Manel ;
Angeles Marcos, Maria ;
Alsina, Laia ;
Saiz, Albert ;
Rosenfeld, Myrna R. ;
Graus, Francesc ;
Dalmau, Josep .
LANCET NEUROLOGY, 2018, 17 (09) :760-772
[4]   A score that predicts 1-year functional status in patients with anti-NMDA receptor encephalitis [J].
Balu, Ramani ;
McCracken, Lindsey ;
Lancaster, Eric ;
Graus, Francesc ;
Dalmau, Josep ;
Titulaer, Maarten J. .
NEUROLOGY, 2019, 92 (03) :E244-E252
[5]   Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis [J].
Bien, Christian G. ;
Vincent, Angela ;
Barnett, Michael H. ;
Becker, Albert J. ;
Bluemcke, Ingmar ;
Graus, Francesc ;
Jellinger, Kurt A. ;
Reuss, David E. ;
Ribalta, Teresa ;
Schlegel, Juergen ;
Sutton, Ian ;
Lassmann, Hans ;
Bauer, Jan .
BRAIN, 2012, 135 :1622-1638
[6]   Malignant tumors in autoimmune encephalitis with anti-NMDA receptor antibodies [J].
Bost, Chloe ;
Chanson, Eve ;
Picard, Geraldine ;
Meyronet, David ;
Mayeur, Marie-Eve ;
Ducray, Francois ;
Rogemond, Veronique ;
Psimaras, Dimitri ;
Antoine, Jean-Christophe ;
Delattre, Jean-Yves ;
Desestret, Virginie ;
Honnorat, Jerome .
JOURNAL OF NEUROLOGY, 2018, 265 (10) :2190-2200
[7]   An expanded parenchymal CD8+ T cell clone in GABAA receptor encephalitis [J].
Bracher, Aline ;
Alcala, Carmen ;
Ferrer, Jaime ;
Melzer, Nico ;
Hohlfeld, Reinhard ;
Casanova, Bonaventura ;
Beltran, Eduardo ;
Dornmair, Klaus .
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY, 2020, 7 (02) :239-244
[8]   Peripheral Immune Cell Ratios and Clinical Outcomes in Seropositive Autoimmune Encephalitis: A Study by the Australian Autoimmune Encephalitis Consortium [J].
Broadley, James ;
Wesselingh, Robb ;
Seneviratne, Udaya ;
Kyndt, Chris ;
Beech, Paul ;
Buzzard, Katherine ;
Nesbitt, Cassie ;
D'Souza, Wendyl ;
Brodtmann, Amy ;
Kalincik, Tomas ;
Butzkueven, Helmut ;
O'Brien, Terence J. ;
Monif, Mastura .
FRONTIERS IN IMMUNOLOGY, 2021, 11
[9]   INFILTRATION OF IMMUNE T-CELLS IN THE BRAIN OF MICE WITH HERPES-SIMPLEX VIRUS-INDUCED ENCEPHALITIS [J].
CHAN, WL ;
JAVANOVIC, T ;
LUKIC, ML .
JOURNAL OF NEUROIMMUNOLOGY, 1989, 23 (03) :195-201
[10]   An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models [J].
Dalmau, Josep ;
Armangue, Thais ;
Planaguma, Jesus ;
Radosevic, Ma ;
Mannara, Francesco ;
Leypoldt, Frank ;
Geis, Christian ;
Lancaster, Eric ;
Titulaer, Maarten J. ;
Rosenfeld, Myrna R. ;
Graus, Francesc .
LANCET NEUROLOGY, 2019, 18 (11) :1045-1057