Evidence map›Paper›PMID 34331009›Full record

ArticleMolecular psychiatry2021

Autoantibodies against NMDA receptor 1 modify rather than cause encephalitis.

Justus B H Wilke, Martin Hindermann, Stefan A Berghoff, Svenja Zihsler, Sahab Arinrad, Anja Ronnenberg, Nadine Barnkothe, Agnes A Steixner-Kumar, Stefan Röglin, Winfried Stöcker and 4 more

Open access · hybridAbstract read
In one paragraph

Article in Molecular psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
1.9field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 25 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Justus B H WilkeClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.ORCID http://orcid.org/0000-0003-1368-159X
Martin HindermannClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Stefan A BerghoffDepartment of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Svenja ZihslerClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Sahab ArinradClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Anja RonnenbergClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Nadine BarnkotheClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Agnes A Steixner-KumarClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.ORCID http://orcid.org/0000-0001-7913-2716
Stefan RöglinClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.
Winfried StöckerInstitute for Experimental Immunology, affiliated to Euroimmun, Lübeck, Germany.
Michael HollmannDepartment of Biochemistry I-Receptor Biochemistry, Ruhr University, Bochum, Germany.
Klaus-Armin NaveDepartment of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.ORCID http://orcid.org/0000-0001-8724-9666
Fred LühderInstitute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Göttingen, Göttingen, Germany.
Hannelore EhrenreichClinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany. ehrenreich@em.mpg.de.ORCID http://orcid.org/0000-0001-8371-5711
Max Planck Institute of Experimental Medicine · DEEuroimmun Medizinische Labordiagnostika (Germany) · DERuhr University Bochum · DEUniversitätsmedizin Göttingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The etiology and pathogenesis of "anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis" and the role of autoantibodies (AB) in this condition are still obscure. While NMDAR1-AB exert NMDAR-antagonistic properties by receptor internalization, no firm evidence exists to date that NMDAR1-AB by themselves induce brain inflammation/encephalitis. NMDAR1-AB of all immunoglobulin classes are highly frequent across mammals with multiple possible inducers and boosters. We hypothesized that "NMDAR encephalitis" results from any primary brain inflammation coinciding with the presence of NMDAR1-AB, which may shape the encephalitis phenotype. Thus, we tested whether following immunization with a "cocktail" of 4 NMDAR1 peptides, induction of a spatially and temporally defined sterile encephalitis by diphtheria toxin-mediated ablation of pyramidal neurons ("DTA" mice) would modify/aggravate the ensuing phenotype. In addition, we tried to replicate a recent report claiming that immunizing just against the NMDAR1-N368/G369 region induced brain inflammation. Mice after DTA induction revealed a syndrome comprising hyperactivity, hippocampal learning/memory deficits, prefrontal cortical network dysfunction, lasting blood brain-barrier impairment, brain inflammation, mainly in hippocampal and cortical regions with pyramidal neuronal death, microgliosis, astrogliosis, modest immune cell infiltration, regional atrophy, and relative increases in parvalbumin-positive interneurons. The presence of NMDAR1-AB enhanced the hyperactivity (psychosis-like) phenotype, whereas all other readouts were identical to control-immunized DTA mice. Non-DTA mice with or without NMDAR1-AB were free of any encephalitic signs. Replication of the reported NMDAR1-N368/G369-immunizing protocol in two large independent cohorts of wild-type mice completely failed. To conclude, while NMDAR1-AB can contribute to the behavioral phenotype of an underlying encephalitis, induction of an encephalitis by NMDAR1-AB themselves remains to be proven.

Indexed as

EncephalitisReceptors, N-Methyl-D-AspartateAnimalsAutoantibodiesBlood-Brain BarrierMicePyramidal CellsAutoantibodiesReceptors, N-Methyl-D-Aspartate

Identifiers

PMID34331009
PMCPMC8872987
OpenAlexW3184021922

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.