Interdisciplinary Institute for Neuroscience, UMR 5297, University of Bordeaux, France; Centre National de la Recherche Scientifique, France.
Institut NeuroMyoGène, Institut National de la Santé et de la Recherche Médicale U1217/Centre National de la Recherche Scientifique UMR 5310, Lyon, France; Hôpital Neurologique, France.
Biol Psychiatry. 2017 Nov 15;82(10):766-772. doi: 10.1016/j.biopsych.2017.06.015. Epub 2017 Jul 6.
Circulating autoantibodies against glutamatergic N-methyl-D-aspartate receptor (NMDAR) have been reported in a proportion of patients with psychotic disorders, raising hopes for more appropriate treatment for these antibody-positive patients. However, the prevalence of circulating autoantibodies against glutamatergic NMDAR in psychotic disorders remains controversial, with detection prevalence rates and immunoglobulin classes varying considerably between studies, perhaps because of different detection methods. Here, we compared the results of serum assays for a large cohort of patients with first-episode psychosis using classical cell-based assays in three labs and a single molecule-based imaging method. Most assays and single molecule imaging in live hippocampal neurons revealed the presence of circulating autoantibodies against glutamatergic NMDAR in approximately 5% of patients with first-episode psychosis. However, some heterogeneity between cell-based assays was clearly observed, highlighting the urgent need for new sensitive methods to detect the presence of low-titer autoantibodies against glutamatergic NMDAR in seropositive patients who cannot be clinically identified from seronegative ones.
循环自身抗体针对谷氨酸能 N-甲基-D-天冬氨酸受体（NMDAR）已在一部分精神病患者中报道，这为这些抗体阳性患者提供了更合适的治疗方法带来了希望。然而，在精神病中循环自身抗体针对谷氨酸能 NMDAR 的患病率仍然存在争议，不同研究之间的检测患病率和免疫球蛋白类别的差异很大，这可能是由于不同的检测方法。在这里，我们使用三种实验室的经典基于细胞的检测方法和一种基于单分子的成像方法，比较了大样本首发精神病患者的血清检测结果。大多数检测方法和活海马神经元的单分子成像显示，约有 5%的首发精神病患者存在循环自身抗体针对谷氨酸能 NMDAR。然而，基于细胞的检测方法之间存在明显的异质性，这突出表明迫切需要新的敏感方法来检测低滴度的循环自身抗体针对谷氨酸能 NMDAR 的存在，而这些抗体在血清阳性患者中无法从血清阴性患者中临床识别。
