August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Neurology Service, Hospital Clinic, University of Barcelona, Barcelona, Spain; Department of Pediatric Neurology, Materno-Infantil Vall d'Hebron Hospital, Autonomous University of Barcelona, Barcelona, Spain.
Ann Neurol. 2014 Feb;75(2):317-23. doi: 10.1002/ana.24083. Epub 2014 Feb 25.
In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p=0.004; cerebrospinal fluid, p=0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity.
在 5 例复发性单纯疱疹后脑炎（HSE）患者中，发现了 N-甲基-D-天冬氨酸受体（NMDAR）抗体。抗体合成始于 HSE 后 1 至 4 周，早于神经复发。5 例患者中有 3 例在免疫治疗后改善，1 例自发改善，1 例开始改善。在对 34 例 HSE 患者进行回顾性评估期间，还发现了另外 2 例 NMDAR 抗体阳性患者、9 例未知神经元表面抗体阳性患者和 1 例 NMDAR 和未知抗体阳性患者；自身抗体的频率随时间增加（血清，p=0.004；脑脊液，p=0.04）。这 3 例回顾性发现的 NMDAR 抗体阳性患者也有复发性 HSE 后证据。总的来说，这些发现表明 HSE 引发了 NMDAR 抗体，并可能引发其他脑自身免疫。
