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与自身免疫性脑炎相关的六种自身抗体在自杀未遂者的脑脊液中无法检测到。

Six autoantibodies associated with autoimmune encephalitis are not detectable in the cerebrospinal fluid of suicide attempters.

作者信息

Fernström Johan, Westrin Åsa, Grudet Cécile, Träskman-Bendz Lil, Brundin Lena, Lindqvist Daniel

机构信息

Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden.

Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden.

出版信息

PLoS One. 2017 Apr 27;12(4):e0176358. doi: 10.1371/journal.pone.0176358. eCollection 2017.

Abstract

Previous findings suggest a link between neuroinflammatory processes and suicidality. Despite several lines of evidence supporting this link, including increased pro-inflammatory markers in blood-, cerebrospinal fluid (CSF)- and in post-mortem brain samples from suicidal individuals, the underlying mechanisms remain poorly understood. In this pilot study, we explored the possibility that autoimmune encephalopathies might be found among suicide attempters. We analysed the presence of six different autoantibodies (N-methyl-D-aspartate receptor, the α-amino-3-hydroxy-5-methyl-4-isoxazol-propionic acid receptor, the γ-amino-butyric acid B-receptor, the leucine-rich, glioma-inactivated 1, the contactin-associated protein-like 2, and the dipeptidyl-peptidase-like protein-6), all previously associated with psychopathology, in CSF samples from 29 unmedicated suicide attempters. Five of these subjects had high CSF/serum albumin ratio, indicative of increased blood-brain-barrier permeability. We were not able to detect any of these autoantibodies in the CSF samples. These pilot data do not support a role for autoimmune encephalopathies in suicidal behaviour, although the presence of lower levels of these autoantibodies cannot be ruled out in these patients.

摘要

先前的研究结果表明神经炎症过程与自杀行为之间存在联系。尽管有几条证据支持这种联系,包括自杀个体的血液、脑脊液(CSF)和死后脑样本中促炎标志物增加,但潜在机制仍知之甚少。在这项初步研究中,我们探讨了自杀未遂者中可能存在自身免疫性脑病的可能性。我们分析了29名未用药自杀未遂者的脑脊液样本中六种不同自身抗体(N-甲基-D-天冬氨酸受体、α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体、γ-氨基丁酸B受体、富含亮氨酸的胶质瘤失活蛋白1、接触蛋白相关蛋白样2和二肽基肽酶样蛋白6)的存在情况,所有这些自身抗体之前都与精神病理学有关。其中五名受试者的脑脊液/血清白蛋白比值较高,表明血脑屏障通透性增加。我们在脑脊液样本中未能检测到任何这些自身抗体。这些初步数据不支持自身免疫性脑病在自杀行为中起作用,尽管不能排除这些患者中存在较低水平的这些自身抗体。

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本文引用的文献

1
The role of inflammation in suicidal behaviour.炎症在自杀行为中的作用。
Acta Psychiatr Scand. 2015 Sep;132(3):192-203. doi: 10.1111/acps.12458.
5
Autoimmune encephalopathies.自身免疫性脑病
Ann N Y Acad Sci. 2015 Mar;1338(1):94-114. doi: 10.1111/nyas.12553. Epub 2014 Oct 14.
6
Anti-NMDA Receptor Encephalitis in Psychiatry.精神科中的抗NMDA受体脑炎
Curr Psychiatry Rev. 2011;7(3):189-193. doi: 10.2174/157340011797183184.

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