title: Anti-NMDA receptor encephalitis. The disorder, the diagnosis and the immunobiology.
abstract: Anti-NMDAR encephalitis is a newly characterized syndrome with a progressive, predictable clinical course and the possibility of effective treatment. Accurate and timely diagnosis is critical to selection and implementation of treatments, and optimal patient outcomes. Outcomes are improved with early diagnosis via indirect immunofluorescence or cell-based assays, and the rapid and appropriate administration of immunosuppressant and anti-psychotic therapies. Three possible scenarios accounting for the immunopathogenesis of anti-NMDAR encephalitis are presented, with the most probable one being that of paraneoplastic autoimmunity. Future efforts in this disorder should focus on elucidating the mechanisms that contribute to initiation of this antibody response, as well as exploring the role of tumors, infectious triggers and immune-reactivation. Finally, accessible tools need to be developed that allow for reliable identification of specific antibody markers against synaptic proteins.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Biology, McMaster University, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5. peeryh@mcmaster.ca
authors.forename: Harry E
authors.initials: HE
authors.lastname: Peery
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Day
authors.forename: Shannon
authors.initials: S
authors.lastname: Dunn
authors.forename: Marvin J
authors.initials: MJ
authors.lastname: Fritzler
authors.forename: Harald
authors.initials: H
authors.lastname: Prüss
authors.forename: Claire
authors.initials: C
authors.lastname: De Souza
authors.forename: Asif
authors.initials: A
authors.lastname: Doja
authors.forename: Karen
authors.initials: K
authors.lastname: Mossman
authors.forename: Lothar
authors.initials: L
authors.lastname: Resch
authors.forename: Chenjie
authors.initials: C
authors.lastname: Xia
authors.forename: Boris
authors.initials: B
authors.lastname: Sakic
authors.forename: Larry
authors.initials: L
authors.lastname: Belbeck
authors.forename: Warren G
authors.initials: WG
authors.lastname: Foster
mesh_terms: D000818:Animals; D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology; D042241:Early Diagnosis; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*
chemical_list: D014150:Antipsychotic Agents; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D016194:Receptors, N-Methyl-D-Aspartate