Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, Sichuan 611730, China; National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Institute of Brain Science and Brain-inspired Technology of West China Hospital, Sichuan University, Chengdu, Sichuan, China; National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Brain Behav Immun. 2024 Feb;116:34-51. doi: 10.1016/j.bbi.2023.11.030. Epub 2023 Nov 27.
Changes in the intestinal microbiota have been observed in patients with anti-N-methyl-D-aspartate receptor encephalitis (NMDARE). However, whether and how the intestinal microbiota is involved in the pathogenesis of NMDARE susceptibility needs to be demonstrated. Here, we first showed that germ-free (GF) mice that underwent fecal microbiota transplantation (FMT) from NMDARE patients, whose fecal microbiota exhibited low short-chain fatty acid content, decreased abundance of Lachnospiraceae, and increased abundance of Verrucomicrobiota, Akkermansia, Parabacteroides, Oscillospirales, showed significant behavioral deficits. Then, these FMT mice were actively immunized with an amino terminal domain peptide from the GluN1 subunit (GluN1356-385) to mimic the pathogenic process of NMDARE. We found that FMT mice showed an increased susceptibility to an encephalitis-like phenotype characterized by more clinical symptoms, greater pentazole (PTZ)-induced susceptibility to seizures, and higher levels of T2 weighted image (T2WI) hyperintensities following immunization. Furthermore, mice with dysbiotic microbiota had impaired blood-brain barrier integrity and a proinflammatory condition. In NMDARE-microbiota recipient mice, the levels of Evan's blue (EB) dye extravasation increased, ZO-1 and claudin-5 expression decreased, and the levels of proinflammatory cytokines (IL-1, IL-6, IL-17, TNF-α and LPS) increased. Finally, significant brain inflammation, mainly in hippocampal and cortical regions, with modest neuroinflammation, immune cell infiltration, and reduced expression of NMDA receptors were observed in NMDARE microbiota recipient mice following immunization. Overall, our findings demonstrated that intestinal dysbiosis increased NMDARE susceptibility, suggesting a new target for limiting the occurrence of the severe phenotype of NMDARE.
抗 N-甲基-D-天冬氨酸受体脑炎 (NMDARE) 患者的肠道微生物群已经发生变化。然而,肠道微生物群是否以及如何参与 NMDARE 易感性的发病机制仍有待证明。在这里,我们首先表明,接受 NMDARE 患者粪便微生物群移植 (FMT) 的无菌 (GF) 小鼠,其粪便微生物群表现出短链脂肪酸含量低、lachnospiraceae 丰度降低和 verrucomicrobiota、Akkermansia、Parabacteroides、Oscillospirales 丰度增加,表现出明显的行为缺陷。然后,这些 FMT 小鼠用谷氨酸 N1 亚基氨基末端结构域肽 (GluN1356-385) 主动免疫,模拟 NMDARE 的发病过程。我们发现,FMT 小鼠对脑炎样表型的易感性增加,表现为更多的临床症状、戊四氮 (PTZ) 诱导的癫痫易感性增加以及免疫后 T2 加权图像 (T2WI) 高信号增加。此外,肠道微生物失调的小鼠血脑屏障完整性受损和促炎状态。在 NMDARE-微生物群接受小鼠中,伊文思蓝 (EB) 染料渗出物水平增加,ZO-1 和闭合蛋白-5 表达减少,促炎细胞因子 (IL-1、IL-6、IL-17、TNF-α 和 LPS) 水平增加。最后,在 NMDARE 微生物群接受小鼠中,在免疫后观察到大脑明显炎症,主要在海马和皮质区域,伴有轻度神经炎症、免疫细胞浸润和 NMDA 受体表达减少。总之,我们的研究结果表明,肠道菌群失调增加了 NMDARE 的易感性,为限制 NMDARE 严重表型的发生提供了一个新的靶点。
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