Anticorps anti-récepteur NMDA dans les premiers épisodes psychotiques
Year: 2014
Type: dissertation
Study design: Observational Study
Abstract: Schizophrenia is a severe disease whose etiopathogenic mechanisms remaining poorly understood. The autoimmune hypothesis in psychosis is supported by many studies. Peripheral inflammation or low-grade neuroinfammation may contribute to glutamatergic NMDA receptor hypofunction which is a core mechanism in schizophrenia. Anti-NMDA receptor limbic encephalitis is an outstanding topic to study the role of autoimmune process in the genesis of psychotic symptoms. This condition is associated with specific IgG anti-NR1 in CSF inducing NMDA receptor diffusion ouf of the synapse and endocytosis. Isolated psychiatric form of the disease or anti-NMDA-R antibodies detection in the sera of schizophrenic cases may suggest that some schizophrenic patients could be considered as mild-encephalitis. In our study, 5 patients (12.5%) of 40 with a first-episode of psychosis were seropositive for IgG anti-NR1 validating precedent studies in schizophrenia. While the pathogenic effects are clearly demonstrated in encephalitis, the involvement of these markers in the genesis of psychotic symptoms in schizophrenia is debated and their pathogenicity remains to be established. The identification of clinical or paraclinical features in carriers could provide new therapeutic approach aiming pathogenic mechanisms.
Source: HAL
Author: Emmanuel Le Guen
Institution: Université Paris Descartes
Language: French
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1545515627