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Normal gut microbiome in NMDA receptor encephalitis.

Julia Herken1, Corinna Bang1, Malte C Rühlemann1

  • 1From the German Center for Neurodegenerative Diseases (DZNE) (J.H., H.P.); Department of Neurology and Experimental Neurology (J.H., C.F., J.K., H.P.), Charité - Universitätsmedizin, Berlin; and Institute of Clinical Molecular Biology (C.B., M.C.R., A.F.), Christian Albrechts University of Kiel, Germany.

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|October 19, 2019
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Summary

The gut microbiome in anti-NMDA receptor (NMDAR) encephalitis patients appears normal, suggesting gut bacteria are not a major factor in disease development or progression. This contrasts with other neuroimmune conditions.

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Area of Science:

  • Neuroimmunology
  • Microbiome Research
  • Gastroenterology

Background:

  • Gut microbiota dysbiosis is implicated in various neuroinflammatory diseases.
  • The role of gut bacteria in anti-NMDA receptor (NMDAR) encephalitis pathogenesis remains unclear.
  • Previous studies in MS and neuromyelitis optica suggest a potential link between gut microbiota and neuroinflammation.

Purpose of the Study:

  • To investigate the gut microbiota composition in patients with NMDAR encephalitis.
  • To determine if specific commensal bacteria are overabundant in NMDAR encephalitis patients.
  • To compare gut microbiome profiles between NMDAR encephalitis patients and healthy controls.

Main Methods:

  • 16S rDNA sequencing of stool samples from 23 NMDAR encephalitis patients and 24 healthy controls.
  • Analysis of intraindividual and interindividual bacterial diversity and differentially abundant taxa.
  • Comparison of microbiome profiles, including specific genera and diversity metrics.

Main Results:

  • No significant differences in overall gut microbiota profiles were observed between NMDAR encephalitis patients and controls.
  • Subgroup analysis of patients with ovarian teratoma showed no microbiome variations.
  • Transient differences in specific bacterial genera (e.g., Clostridium, Prevotella) were noted in the acute stage but lost significance after multiple testing correction.

Conclusions:

  • Patients with NMDAR encephalitis exhibit a normal gut microbiome composition.
  • Gut microbiome alterations are unlikely to be major contributors to NMDAR encephalitis pathogenesis, disease course, or prognosis.
  • Findings suggest distinct microbiome roles in NMDAR encephalitis compared to other neuroimmunologic diseases.