Hansen Niels
Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
Translational Psychoneuroscience, University Medical Center Göttingen, Göttingen, Germany.
J Transl Autoimmun. 2022 Sep 21;5:100165. doi: 10.1016/j.jtauto.2022.100165. eCollection 2022.
-Methyl-d-Aspartate-receptor (NMDAR) antibody encephalitis is a disease discovered two decades ago. Our knowledge about it has recently deepened dramatically. However, the significance of NMDAR antibodies in psychiatric disease cannot be determined if there are no clear indications of brain inflammation or an autoimmune encephalitis mediated by NMDAR antibodies. Furthermore, the long-term interaction and connection between these two disease entities are unclear. In this paper we aim to elucidate the relationship between these disease entities. We propose two distinct models that explain the on the one hand a condition in which a minor inflammatory state as in psychiatric disease culminates in a severe state of inflammation characterized by NMDAR encephalitis. On the other hand, we postulate a model in which an NMDAR encephalitis might later create favorable conditions for inducing psychiatric disease. These models should be kept in mind for further investigations examining the long-term outcome of NMDAR autoantibody immunity in the brain and its functions.
N-甲基-D-天冬氨酸受体（NMDAR）抗体脑炎是二十年前发现的一种疾病。我们对它的了解最近有了显著加深。然而，如果没有明确的脑部炎症迹象或由NMDAR抗体介导的自身免疫性脑炎，就无法确定NMDAR抗体在精神疾病中的意义。此外，这两种疾病实体之间的长期相互作用和联系尚不清楚。在本文中，我们旨在阐明这些疾病实体之间的关系。我们提出了两种不同的模型，一方面解释了一种情况，即精神疾病中轻微的炎症状态最终发展为以NMDAR脑炎为特征的严重炎症状态。另一方面，我们假设一种模型，即NMDAR脑炎可能随后为诱发精神疾病创造有利条件。在进一步研究脑部NMDAR自身抗体免疫及其功能的长期结果时，应牢记这些模型。
