在精神疾病中寻找神经抗体:不确定的发现和影响
1From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., J.D.); Neurology Service (M.G., J.D.), Hospital Clínic de Barcelona, University of Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institution for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain.
Neurology
|June 23, 2023
概括
精神疾病中的抗体缺乏明确的诊断价值,与自身免疫性脑炎 (AE) 不同. 临床判断至关重要,因为许多抗体测试具有有限的特异性,可以产生假阳性,使神经学咨询复杂化.
科学领域:
- 神经免疫学 神经免疫学
- 精神病学是一个精神病学.
- 神经学 神经学
背景情况:
- 最近的文献显示,许多报告将个体精神症状与特定抗体联系起来,这些抗体通常被呈现为不同的疾病.
- 虽然对神经元表面蛋白的抗体是诊断自身免疫性脑炎 (AE) 的关键,但它们在精神疾病中的作用尚不清楚,往往缺乏严格的研究.
- 研究经常引用抗N-甲基-D-酸盐受体脑炎作为模型,但未能复制其对精神疾病的调查严格性.
研究的目的:
- 批判性地评估精神疾病中抗体检测的诊断和临床意义.
- 突出神经学和精神病学当前抗体测试方法的局限性和潜在陷.
- 强调临床判断在解释抗体发现在神经和精神症状的背景下的重要性.
主要方法:
- 关于自身免疫性脑炎和精神疾病中抗体检测的当前文献的综述.
- 对特定抗体发现的分析,包括GAD65,TPO,VGKC,Ma2,Zic4,SOX1和GlyR抗体.
- 检查抗体检测的局限性,例如假阳性率,缺乏疾病特异性以及生物样本的问题.
主要成果:
- 对神经元表面蛋白的抗体与AE中不同的,对治疗有反应性的疾病有关.
- 相比之下,在精神疾病中检测抗体并没有定义特定疾病或改善诊断和治疗.
- 一些抗体测试具有显著的局限性,包括高的假阳性率 (例如,Ma2,Zic4,SOX1) 和不清楚的疾病特异性 (例如,GlyR,对未知抗原的抗体).
- 一些抗体 (GAD65,TPO) 在健康个体中被发现,而VGKC抗体需要进一步调查LGI1或CASPR2.
结论:
- 由于方法上的局限性和缺乏特异性,在精神疾病中抗体的诊断效用是可疑的.
- 在抗体可靠地用于精神病诊断之前,需要与AE类似的严格调查和验证.
- 在解释抗体发现时,临床判断仍然至关重要,特别是当面临潜在的假阳性和不清楚的致病意义时.
更多相关视频
相关概念视频
Neural Regulation
39.6K
Digestion begins with a cephalic phase that prepares the digestive system to receive food. When our brain processes visual or olfactory information about food, it triggers impulses in the cranial nerves innervating the salivary glands and stomach to prepare for food.
39.6K
Biological Causes of Schizophrenia
104
Schizophrenia, a severe psychiatric disorder, arises from a complex interplay of biological factors, including genetic predisposition, structural brain abnormalities, neurotransmitter dysregulation, and developmental irregularities. These factors collectively contribute to the onset and progression of the disorder, which typically manifests in late adolescence or early adulthood.
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
Genetic Factors in Schizophrenia
The genetic basis of schizophrenia is strongly supported by family and twin...
104
Disorders of the Nervous Tissue
1.4K
Nervous tissue is a vital component of the human body's communication system, enabling us to perceive and respond to stimuli. However, like all other tissues, it is vulnerable to disorders and diseases that can significantly impact our neurological functioning.
Homeostatic Imbalances:
Alzheimer's disease manifests as a gradual decline in memory and cognitive abilities, attributed to the buildup of amyloid plaques and neurofibrillary tangles in the brain.
Parkinson's disease arises from the...
Homeostatic Imbalances:
Alzheimer's disease manifests as a gradual decline in memory and cognitive abilities, attributed to the buildup of amyloid plaques and neurofibrillary tangles in the brain.
Parkinson's disease arises from the...
1.4K
Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
763
Schizophrenia is a neurodevelopmental disorder whose origins are rooted in complex genetic components. Despite our burgeoning understanding, the pathophysiology of this disorder remains incompletely deciphered.
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
763
Alzheimer's Disease: Treatment
222
Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
222


