title: Herpes simplex virus encephalitis is a trigger of brain autoimmunity.
abstract: 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.
authors: August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Neurology Service, Hospital Clinic, University of Barcelona, Barcelona, Spain; Department of Pediatric Neurology, Materno-Infantil Vall d'Hebron Hospital, Autonomous University of Barcelona, Barcelona, Spain.
authors: Thaís
authors: T
authors: Armangue
authors: Frank
authors: F
authors: Leypoldt
authors: Ignacio
authors: I
authors: Málaga
authors: Miquel
authors: M
authors: Raspall-Chaure
authors: Itxaso
authors: I
authors: Marti
authors: Charles
authors: C
authors: Nichter
authors: John
authors: J
authors: Pugh
authors: Monica
authors: M
authors: Vicente-Rasoamalala
authors: Miguel
authors: M
authors: Lafuente-Hidalgo
authors: Alfons
authors: A
authors: Macaya
authors: Michael
authors: M
authors: Ke
authors: Maarten J
authors: MJ
authors: Titulaer
authors: Romana
authors: R
authors: Höftberger
authors: Heather
authors: H
authors: Sheriff
authors: Carol
authors: C
authors: Glaser
authors: Josep
authors: J
authors: Dalmau
mesh_terms: D000818:Animals; D015551:Autoimmunity / Q000502:physiology*; D001921:Brain / Q000503:physiopathology*; D002675:Child, Preschool; D020803:Encephalitis, Herpes Simplex / Q000097:blood / Q000134:cerebrospinal fluid / Q000473:pathology*; D005260:Female; D057809:HEK293 Cells; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D051381:Rats; D016194:Receptors, N-Methyl-D-Aspartate / Q000097:blood; D012189:Retrospective Studies; D014162:Transfection; D055815:Young Adult
chemical_list: D016194:Receptors, N-Methyl-D-Aspartate