Herpes simplex virus encephalitis is a trigger of brain autoimmunity

作者：Armangue, Thais; Leypoldt, Frank; Malaga, Ignacio; Raspall-Chaure, Miquel; Marti, Itxaso; Nichter, Charles; Pugh, John; Vicente-Rasoamalala, Monica; Lafuente-Hidalgo, Miguel; Macaya, Alfons; Ke, Michael; Titulaer, Maarten J.; Hoeftberger, Romana; Sheriff, Heather; Glaser, Carol; Dalmau, Josep^*

来源：Annals of Neurology, 2014, 75(2): 317-323.

DOI：10.1002/ana.24083

• NMDA-RECEPTOR ENCEPHALITIS
• D-ASPARTATE RECEPTOR
• COMBINATION THERAPY
• ANTIBODIES
• RELAPSE
• ACYCLOVIR

In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p = 0.004; cerebrospinal fluid, p = 0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity. Ann Neurol 2014;75:317-323

• 出版日期2014-2