Kelleher Eric, Barry Helen, Cotter David R, Corvin Aiden, Murphy Kieran C
Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland.
Department of Psychiatry, Royal College of Surgeons of Ireland, Dublin, Ireland.
Curr Top Behav Neurosci. 2020;44:85-123. doi: 10.1007/7854_2019_90.
Research into antibody-mediated disease, in response to immune dysfunction or to tumour development, has rapidly expanded in recent years. Antibodies binding to neuroreceptors can cause psychiatric features, including psychosis, in a minority of patients as well as neurological features. The responsiveness of some of these cases to immunotherapy supports the hypothesis that antibody-associated mechanisms play a role in the pathogenesis of psychotic diseases. The purpose of this chapter is to review autoantibodies that are most likely to be relevant for patients with psychotic symptoms. Herein, we describe receptor structure and mechanism of action, clinical and psychiatric features for the growing number of neuronal surface antibodies, including those to the N-methyl-D-aspartate (NMDA) receptor. The identification of a subgroup of patients with psychiatric features having antibody-mediated disease highlights the importance of considering the diagnosis, particularly in those patients presenting with a first episode of psychosis.
近年来，针对免疫功能障碍或肿瘤发展所引发的抗体介导疾病的研究迅速扩展。与神经受体结合的抗体在少数患者中可引发包括精神病在内的精神症状以及神经症状。其中一些病例对免疫疗法的反应支持了抗体相关机制在精神病性疾病发病机制中起作用的假说。本章的目的是综述那些最有可能与有精神病症状患者相关的自身抗体。在此，我们描述了越来越多的神经元表面抗体（包括针对N-甲基-D-天冬氨酸（NMDA）受体的抗体）的受体结构、作用机制、临床和精神特征。对具有抗体介导疾病的精神症状患者亚组的识别凸显了考虑该诊断的重要性，尤其是在那些首次出现精神病发作的患者中。
