Cervical lymph nodes and ovarian teratomas as germinal centres in NMDA receptor-antibody encephalitis

Autoantibodies against the extracellular domain of the N-methyl-d-aspartate receptor (NMDAR) NR1 subunit cause a severe and common form of encephalitis. To better understand their generation, we aimed to characterize and identify human germinal centres actively participating in NMDAR-specific autoim...

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Published in:Brain (London, England : 1878) England : 1878), 2022-08, Vol.145 (8), p.2742-2754
Main Authors: 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, Soleymani Majd, Hooman, 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
Format: Article
Language:English
Subjects:
Anti-N-Methyl-D-Aspartate Receptor Encephalitis
Autoantibodies
Female
Germinal Center
Humans
Immunoglobulin A
Immunoglobulin G
Lymphatic Vessels
Medicin och hälsovetenskap
Original
Ovarian Neoplasms
Receptors, N-Methyl-D-Aspartate
Teratoma
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Summary:Autoantibodies against the extracellular domain of the N-methyl-d-aspartate receptor (NMDAR) NR1 subunit cause a severe and common form of encephalitis. To better understand their generation, we aimed to characterize and identify human germinal centres actively participating in NMDAR-specific autoimmunization by sampling patient blood, CSF, ovarian teratoma tissue and, directly from the putative site of human CNS lymphatic drainage, cervical lymph nodes. From serum, both NR1-IgA and NR1-IgM were detected more frequently in NMDAR-antibody encephalitis patients versus controls (both P 
ISSN:0006-8950
1460-2156
1460-2156
DOI:10.1093/brain/awac088