抗N–methyl–D–aspartate受容体脳炎の動向
「はじめに」 脳炎/脳症は命を脅かす疾患であり, 多くの原因がある. N-methyl-d-Aspartate(NMDA)受容体脳炎の確立は, 2007年米国ペンシルバニア大学(現バルセロナ大学)のDalmauらが, 卵巣奇形腫に合併した12例の脳炎をまとめ, 奇形腫の神経細胞に発現するNMDA受容体サブユニットに対するNR1/NR2 heteromer抗体を検出し, NMDA受容体脳炎として報告したことにはじまる. この報告以後本症を含めた自己免疫性脳炎(autoimmune encephalitis: AE)の研究の進歩は著しく, 多くの神経抗体やその病像が解明されてきた. NMDA受容体...
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| Published in | 神経治療学 Vol. 39; no. 3; pp. 327 - 331 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本神経治療学会
2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0916-8443 2189-7824 |
| DOI | 10.15082/jsnt.39.3_327 |
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| Abstract | 「はじめに」 脳炎/脳症は命を脅かす疾患であり, 多くの原因がある. N-methyl-d-Aspartate(NMDA)受容体脳炎の確立は, 2007年米国ペンシルバニア大学(現バルセロナ大学)のDalmauらが, 卵巣奇形腫に合併した12例の脳炎をまとめ, 奇形腫の神経細胞に発現するNMDA受容体サブユニットに対するNR1/NR2 heteromer抗体を検出し, NMDA受容体脳炎として報告したことにはじまる. この報告以後本症を含めた自己免疫性脳炎(autoimmune encephalitis: AE)の研究の進歩は著しく, 多くの神経抗体やその病像が解明されてきた. NMDA受容体脳炎は脳炎全体の4%を占め, 脳炎全体の4%を占めAEの中で最も頻度が高いと考えられている. 本稿では, NMDA受容体脳炎の最近の動向について, 1. 診断・臨床像の進展, 2. 発症機序および3. 治療動向の順で概説する. |
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| AbstractList | 「はじめに」 脳炎/脳症は命を脅かす疾患であり, 多くの原因がある. N-methyl-d-Aspartate(NMDA)受容体脳炎の確立は, 2007年米国ペンシルバニア大学(現バルセロナ大学)のDalmauらが, 卵巣奇形腫に合併した12例の脳炎をまとめ, 奇形腫の神経細胞に発現するNMDA受容体サブユニットに対するNR1/NR2 heteromer抗体を検出し, NMDA受容体脳炎として報告したことにはじまる. この報告以後本症を含めた自己免疫性脳炎(autoimmune encephalitis: AE)の研究の進歩は著しく, 多くの神経抗体やその病像が解明されてきた. NMDA受容体脳炎は脳炎全体の4%を占め, 脳炎全体の4%を占めAEの中で最も頻度が高いと考えられている. 本稿では, NMDA受容体脳炎の最近の動向について, 1. 診断・臨床像の進展, 2. 発症機序および3. 治療動向の順で概説する. |
| Author | 亀井, 聡 |
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| References | 9) Bastiaansen AEM, van Steenhoven RW, de Bruijn MAAM et al : Autoimmune Encephalitis Resembling Dementia Syndromes. Neurol Neuroimmunol Neuroinflamm 8 : e1039, 2021 4) Dalmau J, Armangué T, Planagumà J et al : An update on anti–NMDA receptor encephalitis for neurologists and psychiatrists : mechanisms and models. Lancet Neurol 18 : 1045–1057, 2019 3) Graus F, Titulaer MJ, Balu R et al : A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 15 : 391–404, 2016 11) Huang Q, Xie Y, Hu Z et al : Anti–N–methyl–D–aspartate receptor encephalitis : A review of pathogenic mechanisms, treatment, prognosis. Brain Res 1727 : 146549, 2020 16) Dalmau J : NMDA receptor encephalitis and other antibody–mediated disorders of the synapse. The 2016 Cotzias Lecture. Neurology 87 : 24712482, 2016 17) Dai Y, Zhang J, Ren H et al : Surgical outcomes in patients with anti–N–methyl D–aspartate receptor encephalitis with ovarian teratoma. Am J Obstet Gynecol 221 : 485.e1–485.e10, 2019 10) Ghosh A : Neurobiology. Learning more about NMDA receptor regulation. Science 295 : 449–451, 2002 12) Dalmau J, Lancaster E, Martinez–Hernandez E et al : Clinical experience and laboratory investigations in patients with anti–NMDAR encephalitis. Lancet Neurol 10 : 63–74, 2011 19) Personal communication from Dalmau J (American Academy of Neurology 2017 21) Scheibe F, Prüss H, Mengel AM et al : Bortezomib for treatment of therapy–refractory anti–NMDA receptor encephalitis. Neurology 88 : 366–370, 2017 2) Granerod J, Ambrose HE, Davies NW et al : Causes of encephalitis and differences in their clinical presentations in England : a multicentre, population–based prospective study. Lancet Infect Dis 10 : 835–844, 2010 7) McKeon A, Dubey D, Flanagan E et al : Autoimmune psychosis. Lancet Psychiatry 7 : 122, 2020 5) Lennox BR, Palmer–Cooper EC, Pollak T et al : Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first–episode psychosis : a case–control study. Lancet Psychiatry 4 : 42–48, 2017 15) Huang YQ, Xiong H : Anti–NMDA receptor encephalitis : a review of mechanistic studies. Int J Physiol Pathophysiol Pharmacol 13 : 1–11, 2021 18) van Sonderen A, Petit–Pedrol M, Dalmau J et al : The value of LGI1, Caspr2 and voltage–gated potassium channel antibodies in encephalitis. Nat Rev Neurol 13 : 290–301, 2017 1) Dalmau J, Tüzün E, Wu HY et al : Paraneoplastic anti–N–methyl–D–aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 61 : 25–36, 2007 23) Feyissa AM, López Chiriboga AS, Britton JW : Antiepileptic drug therapy in patients with autoimmune epilepsy. Neurol Neuroimmunol Neuroinflamm 4 : e353, 2017 14) Gardoni F, Stanic J, Scheggia D et al : NMDA and AMPA Receptor Autoantibodies in Brain Disorders : From Molecular Mechanisms to Clinical Features. Cells 10 : 77, 2021 13) Mikasova L, De Rossi P, Bouchet D et al : Disrupted surface cross–talk between NMDA and Ephrin–B2 receptors in anti–NMDA encephalitis. Brain 135 : 1606–1621, 2012 22) Dinoto A, Cheli M, Bratina A et al : Bortezomib in anti–N–Methyl–d–Aspartate–Receptor (NMDA–R) encephalitis : A systematic review. J Neuroimmunol 356 : 577586, 2021 6) Pollak TA, Lennox BR, Müller S et al : Autoimmune psychosis : an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. Lancet Psychiatry 7 : 93–108, 2020 8) Kuehn JC, Meschede C, Helmstaedter C et al : Adult–onset temporal lobe epilepsy suspicious for autoimmune pathogenesis : Autoantibody prevalence and clinical correlates. PLoS One 15 : e0241289, 2020 20) Lee WJ, Lee ST, Moon J et al : Tocilizumab in Autoimmune Encephalitis Refractory to Rituximab : An Institutional Cohort Study. Neurotherapeutics 13 : 824–832, 2016 |
| References_xml | – reference: 18) van Sonderen A, Petit–Pedrol M, Dalmau J et al : The value of LGI1, Caspr2 and voltage–gated potassium channel antibodies in encephalitis. Nat Rev Neurol 13 : 290–301, 2017 – reference: 14) Gardoni F, Stanic J, Scheggia D et al : NMDA and AMPA Receptor Autoantibodies in Brain Disorders : From Molecular Mechanisms to Clinical Features. Cells 10 : 77, 2021 – reference: 8) Kuehn JC, Meschede C, Helmstaedter C et al : Adult–onset temporal lobe epilepsy suspicious for autoimmune pathogenesis : Autoantibody prevalence and clinical correlates. PLoS One 15 : e0241289, 2020 – reference: 15) Huang YQ, Xiong H : Anti–NMDA receptor encephalitis : a review of mechanistic studies. Int J Physiol Pathophysiol Pharmacol 13 : 1–11, 2021 – reference: 5) Lennox BR, Palmer–Cooper EC, Pollak T et al : Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first–episode psychosis : a case–control study. Lancet Psychiatry 4 : 42–48, 2017 – reference: 6) Pollak TA, Lennox BR, Müller S et al : Autoimmune psychosis : an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. Lancet Psychiatry 7 : 93–108, 2020 – reference: 23) Feyissa AM, López Chiriboga AS, Britton JW : Antiepileptic drug therapy in patients with autoimmune epilepsy. Neurol Neuroimmunol Neuroinflamm 4 : e353, 2017 – reference: 16) Dalmau J : NMDA receptor encephalitis and other antibody–mediated disorders of the synapse. The 2016 Cotzias Lecture. Neurology 87 : 24712482, 2016 – reference: 7) McKeon A, Dubey D, Flanagan E et al : Autoimmune psychosis. Lancet Psychiatry 7 : 122, 2020 – reference: 21) Scheibe F, Prüss H, Mengel AM et al : Bortezomib for treatment of therapy–refractory anti–NMDA receptor encephalitis. Neurology 88 : 366–370, 2017 – reference: 11) Huang Q, Xie Y, Hu Z et al : Anti–N–methyl–D–aspartate receptor encephalitis : A review of pathogenic mechanisms, treatment, prognosis. Brain Res 1727 : 146549, 2020 – reference: 1) Dalmau J, Tüzün E, Wu HY et al : Paraneoplastic anti–N–methyl–D–aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 61 : 25–36, 2007 – reference: 3) Graus F, Titulaer MJ, Balu R et al : A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 15 : 391–404, 2016 – reference: 4) Dalmau J, Armangué T, Planagumà J et al : An update on anti–NMDA receptor encephalitis for neurologists and psychiatrists : mechanisms and models. Lancet Neurol 18 : 1045–1057, 2019 – reference: 22) Dinoto A, Cheli M, Bratina A et al : Bortezomib in anti–N–Methyl–d–Aspartate–Receptor (NMDA–R) encephalitis : A systematic review. J Neuroimmunol 356 : 577586, 2021 – reference: 9) Bastiaansen AEM, van Steenhoven RW, de Bruijn MAAM et al : Autoimmune Encephalitis Resembling Dementia Syndromes. Neurol Neuroimmunol Neuroinflamm 8 : e1039, 2021 – reference: 17) Dai Y, Zhang J, Ren H et al : Surgical outcomes in patients with anti–N–methyl D–aspartate receptor encephalitis with ovarian teratoma. Am J Obstet Gynecol 221 : 485.e1–485.e10, 2019 – reference: 2) Granerod J, Ambrose HE, Davies NW et al : Causes of encephalitis and differences in their clinical presentations in England : a multicentre, population–based prospective study. Lancet Infect Dis 10 : 835–844, 2010 – reference: 13) Mikasova L, De Rossi P, Bouchet D et al : Disrupted surface cross–talk between NMDA and Ephrin–B2 receptors in anti–NMDA encephalitis. Brain 135 : 1606–1621, 2012 – reference: 19) Personal communication from Dalmau J (American Academy of Neurology 2017) – reference: 20) Lee WJ, Lee ST, Moon J et al : Tocilizumab in Autoimmune Encephalitis Refractory to Rituximab : An Institutional Cohort Study. Neurotherapeutics 13 : 824–832, 2016 – reference: 10) Ghosh A : Neurobiology. Learning more about NMDA receptor regulation. Science 295 : 449–451, 2002 – reference: 12) Dalmau J, Lancaster E, Martinez–Hernandez E et al : Clinical experience and laboratory investigations in patients with anti–NMDAR encephalitis. Lancet Neurol 10 : 63–74, 2011 |
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| Title | 抗N–methyl–D–aspartate受容体脳炎の動向 |
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