抗 NMDAR 或 VGKC 复合物抗体阴性的 GAD 和心磷脂抗体阳性的耐药性癫痫。
Lack of antibodies to NMDAR or VGKC-complex in GAD and cardiolipin antibody-positive refractory epilepsy.
机构信息
Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland; Department of Emergency Medicine, Tampere University Hospital, Tampere, Finland.
Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland.
出版信息
Epilepsy Res. 2014 Mar;108(3):592-6. doi: 10.1016/j.eplepsyres.2013.12.015. Epub 2014 Jan 6.
BACKGROUND
Over the last few years autoantibodies against neuronal proteins have been identified in several forms of autoimmune encephalitis and epilepsy. NMDA receptor (NMDAR) and voltage gated potassium channel (VGKC) complex antibodies are mainly associated with limbic encephalitis (LE) whereas glutamic acid decarboxylase antibodies (GADA) and anticardiolipin (ACL) antibodies are more commonly detected in patients with chronic epilepsy. Clinical features vary between these antibodies suggesting the specificity of different neuronal antibodies in seizures.
METHODS
Serum samples of 14 GADA positive and 24 ACL positive patients with refractory epilepsy were analyzed for the presence of VGKC or NMDAR antibodies.
RESULTS
No positive VGKC or NMDAR antibodies were found in these patients.
CONCLUSIONS
The results confirm the different significance of these neuronal antibodies in seizure disorders. Different autoantibodies have different significance in seizures and probably have different pathophysiological mechanisms of actions.
背景
在过去几年中，自身抗体针对神经元蛋白已在几种自身免疫性脑炎和癫痫中被鉴定。N-甲基-D-天冬氨酸受体（NMDAR）和电压门控钾通道（VGKC）复合物抗体主要与边缘性脑炎（LE）相关，而谷氨酸脱羧酶抗体（GADA）和抗心磷脂（ACL）抗体在慢性癫痫患者中更常被检测到。这些抗体之间的临床表现有所不同，提示不同神经元抗体在癫痫发作中的特异性。
方法
对 14 例 GADA 阳性和 24 例 ACL 阳性的难治性癫痫患者的血清样本进行分析，以检测 VGKC 或 NMDAR 抗体。
结果
这些患者中均未发现阳性的 VGKC 或 NMDAR 抗体。
结论
结果证实了这些神经元抗体在癫痫发作中的不同意义。不同的自身抗体在癫痫发作中有不同的意义，可能具有不同的病理生理作用机制。
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