Autoantibodies against NMDA receptor 1 modify rather than cause encephalitis.


Journal

Molecular psychiatry
ISSN: 1476-5578
Titre abrégé: Mol Psychiatry
Pays: England
ID NLM: 9607835

Informations de publication

Date de publication:
12 2021
Historique:
received: 28 04 2021
accepted: 09 07 2021
revised: 06 07 2021
pubmed: 1 8 2021
medline: 15 3 2022
entrez: 31 7 2021
Statut: ppublish

Résumé

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.

Identifiants

pubmed: 34331009
doi: 10.1038/s41380-021-01238-3
pii: 10.1038/s41380-021-01238-3
pmc: PMC8872987
doi:

Substances chimiques

Autoantibodies 0
Receptors, N-Methyl-D-Aspartate 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

7746-7759

Informations de copyright

© 2021. The Author(s).

Références

Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Lai M, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008;7:1091–8.
pubmed: 18851928 pmcid: 2607118 doi: 10.1016/S1474-4422(08)70224-2
Dalmau J, Tüzün E, Wu HY, Masjuan J, Rossi JE, Voloschin A, et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 2007;61:25–36.
pubmed: 17262855 pmcid: 2430743 doi: 10.1002/ana.21050
Hughes EG, Peng X, Gleichman AJ, Lai M, Zhou L, Tsou R, et al. Cellular and synaptic mechanisms of anti-NMDA receptor encephalitis. J Neurosci. 2010;30:5866–75.
pubmed: 20427647 pmcid: 2868315 doi: 10.1523/JNEUROSCI.0167-10.2010
Manto M, Dalmau J, Didelot A, Rogemond V, Honnorat J. In vivo effects of antibodies from patients with anti-NMDA receptor encephalitis: further evidence of synaptic glutamatergic dysfunction. Orphanet J Rare Dis. 2010;5:1–12.
doi: 10.1186/1750-1172-5-31
Mikasova L, De Rossi P, Bouchet D, Georges F, Rogemond V, Didelot A, et al. Disrupted surface cross-talk between NMDA and Ephrin-B2 receptors in anti-NMDA encephalitis. Brain 2012;135:1606–21.
pubmed: 22544902 doi: 10.1093/brain/aws092
Hammer C, Stepniak B, Schneider A, Papiol S, Tantra M, Begemann M, et al. Neuropsychiatric disease relevance of circulating anti-NMDA receptor autoantibodies depends on blood-brain barrier integrity. Mol Psychiatry. 2014;19:1143–9.
pubmed: 23999527 doi: 10.1038/mp.2013.110
Wright S, Hashemi K, Stasiak L, Bartram J, Lang B, Vincent A, et al. Epileptogenic effects of NMDAR antibodies in a passive transfer mouse model. Brain 2015;138:3159–67.
pubmed: 26373601 doi: 10.1093/brain/awv257
Li Y, Tanaka K, Wang L, Ishigaki Y, Kato N. Induction of memory deficit in mice with chronic exposure to cerebrospinal fluid from patients with Anti-N-Methyl-D-Aspartate receptor encephalitis. Tohoku J Exp Med. 2015;237:329–38.
pubmed: 26616272 doi: 10.1620/tjem.237.329
Würdemann T, Kersten M, Tokay T, Guli X, Kober M, Rohde M, et al. Stereotactic injection of cerebrospinal fluid from anti-NMDA receptor encephalitis into rat dentate gyrus impairs NMDA receptor function. Brain Res. 2016;1633:10–8.
pubmed: 26721688 doi: 10.1016/j.brainres.2015.12.027
Planagumà J, Leypoldt F, Mannara F, Gutiérrez-Cuesta J, Martín-García E, Aguilar E, et al. Human N-methyl D-aspartate receptor antibodies alter memory and behaviour in mice. Brain 2015;138:94–109.
pubmed: 25392198 doi: 10.1093/brain/awu310
Blome R, Bach W, Guli X, Porath K, Sellmann T, Bien CG, et al. Differentially altered NMDAR dependent and independent long-term potentiation in the CA3 subfield in a model of anti-NMDAR encephalitis. Front Synaptic Neurosci. 2018;10:1–13.
Kersten M, Rabbe T, Blome R, Porath K, Sellmann T, Bien CG, et al. Novel object recognition in rats with NMDAR dysfunction in CA1 after stereotactic injection of anti-NMDAR encephalitis cerebrospinal fluid. Front Neurol. 2019;10:1–11.
Taraschenko O, Fox HS, Pittock SJ, Zekeridou A, Gafurova M, Eldridge E, et al. A mouse model of seizures in anti-N-methyl-d-aspartate receptor encephalitis. Epilepsia. 2019;60:452–63.
pubmed: 30740690 pmcid: 6684284 doi: 10.1111/epi.14662
Chen X, Li JM, Liu F, Wang Q, Zhou D, Lai X. Anti-N-methyl-D-aspartate receptor encephalitis: a common cause of encephalitis in the intensive care unit. Neurol Sci. 2016;37:1993–8.
pubmed: 27620725 doi: 10.1007/s10072-016-2702-y
Jones BE, Tovar KR, Goehring A, Jalali-Yazdi F, Okada NJ, Gouaux E, et al. Autoimmune receptor encephalitis in mice induced by active immunization with conformationally stabilized holoreceptors. Sci Transl Med. 2019;11:eaaw0044.
Ehrenreich H, Pan H, Hollmann M. RE: Active immunization, autoimmunity and encephalitis: the missing links. Sci Transl Med. 2019. https://stm.sciencemag.org/content/11/500/eaaw0044/tab-e-letters .
Wagnon I, Hélie P, Bardou I, Regnauld C, Lesec L, Leprince J, et al. Autoimmune encephalitis mediated by B-cell response against N-methyl-d-aspartate receptor. Brain. 2020;143:2957–72.
pubmed: 32893288 doi: 10.1093/brain/awaa250
Diamond B, Huerta PT, Mina-Osorio P, Kowal C, Volpe BT. Losing your nerves? Maybe it’s the antibodies. Nat Rev Immunol. 2009;9:449–56.
pubmed: 19424277 pmcid: 2783680 doi: 10.1038/nri2529
Crisp SJ, Kullmann DM, Vincent A. Autoimmune synaptopathies. Nat Rev Neurosci. 2016;17:103–17.
pubmed: 26806629 doi: 10.1038/nrn.2015.27
Nagele EP, Han M, Acharya NK, DeMarshall C, Kosciuk MC, Nagele RG. Natural IgG autoantibodies are abundant and ubiquitous in human sera, and their number is influenced by age, gender, and disease. PLoS One. 2013;8:e60726.
pubmed: 23589757 pmcid: 3617628 doi: 10.1371/journal.pone.0060726
Pollak TA, Lennox BR, Müller S, Benros ME, Prüss H, Tebartz van Elst L, et al. Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. Lancet Psychiatry. 2020;7:93–108.
pubmed: 31669058 doi: 10.1016/S2215-0366(19)30290-1
Cohen IR, Young DB. Autoimmunity, microbial immunity and the immunological homunculus. Immunol Today. 1991;12:105–10.
pubmed: 2059311 doi: 10.1016/0167-5699(91)90093-9
Prüss H, Finke C, Höltje M, Hofmann J, Klingbeil C, Probst C, et al. N-methyl-D-aspartate receptor antibodies in herpes simplex encephalitis. Ann Neurol. 2012;72:902–11.
pubmed: 23280840 pmcid: 3725636 doi: 10.1002/ana.23689
Armangue T, Moris G, Cantarín-Extremera V, Conde CE, Rostasy K, Erro ME, et al. Autoimmune post-herpes simplex encephalitis of adults and teenagers. Neurology. 2015;85:1736–43.
pubmed: 26491084 pmcid: 4653102 doi: 10.1212/WNL.0000000000002125
Pan H, Steixner-Kumar AA, Seelbach A, Deutsch N, Ronnenberg A, Tapken D, et al. Multiple inducers and novel roles of autoantibodies against the obligatory NMDAR subunit NR1: a translational study from chronic life stress to brain injury. Mol Psychiatry. 2020. https://doi.org/10.1038/s41380-020-0672-1 .
Castillo-Gomez E, Kästner A, Steiner J, Schneider A, Hettling B, Poggi G, et al. The brain as immunoprecipitator of serum autoantibodies against N-Methyl-D-aspartate receptor subunit NR1. Ann Neurol. 2016;79:144–51.
pubmed: 26505629 doi: 10.1002/ana.24545
Dalmau J, Armangué T, Planagumà J, Radosevic M, Mannara F, Leypoldt F, et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. Lancet Neurol. 2019;18:1045–57.
pubmed: 31326280 doi: 10.1016/S1474-4422(19)30244-3
Pan H, Oliveira B, Saher G, Dere E, Tapken D, Mitjans M, et al. Uncoupling the widespread occurrence of anti-NMDAR1 autoantibodies from neuropsychiatric disease in a novel autoimmune model. Mol Psychiatry. 2019;24:1489–501.
pubmed: 29426955 doi: 10.1038/s41380-017-0011-3
Dere E, Ronnenberg A, Tampe B, Arinrad S, Schmidt M, Zeisberg E, et al. Cognitive, emotional and social phenotyping of mice in an observer-independent setting. Neurobiol Learn Mem. 2018;150:136–50.
pubmed: 29474958 doi: 10.1016/j.nlm.2018.02.023
Agarwal A, Dibaj P, Kassmann CM, Goebbels S, Nave KA, Schwab MH. In vivo imaging and noninvasive ablation of pyramidal neurons in adult NEX-CreERT2 mice. Cereb Cortex. 2012;22:1473–86.
pubmed: 21880656 doi: 10.1093/cercor/bhr214
Ivanova A, Signore M, Caro N, Greene ND, Copp AJ, Martinez-Barbera JP. In vivo genetic ablation by Cre-mediated expression of diphtheria toxin fragment A. Genes. 2005;43:129–35.
doi: 10.1002/gene.20162
El-Kordi A, Winkler D, Hammerschmidt K, Kästner A, Krueger D, Ronnenberg A, et al. Development of an autism severity score for mice using Nlgn4 null mutants as a construct-valid model of heritable monogenic autism. Behav Brain Res. 2013;251:41–9.
pubmed: 23183221 doi: 10.1016/j.bbr.2012.11.016
Dere E, Dahm L, Lu D, Hammerschmidt K, Ju A, Tantra M, et al. Heterozygous ambra1 deficiency in mice: a genetic trait with autism-like behavior restricted to the female gender. Front Behav Neurosci. 2014;8:1–19.
Dere E, Winkler D, Ritter C, Ronnenberg A, Poggi G, Patzig J, et al. Gpm6b deficiency impairs sensorimotor gating and modulates the behavioral response to a 5-HT2A/C receptor agonist. Behav Brain Res. 2015;277:254–63.
pubmed: 24768641 doi: 10.1016/j.bbr.2014.04.021
Janova H, Arinrad S, Balmuth E, Mitjans M, Hertel J, Habes M, et al. Microglia ablation alleviates myelin-associated catatonic signs in mice. J Clin Invest. 2018;128:734–45.
pubmed: 29252214 doi: 10.1172/JCI97032
Garcia-Agudo LF, Janova H, Sendler LE, Arinrad S, Steixner AA, Hassouna I, et al. Genetically induced brain inflammation by Cnp deletion transiently benefits from microglia depletion. FASEB J. 2019;33:8634–47.
pubmed: 31090455 doi: 10.1096/fj.201900337R
Winkler D, Daher F, Wüstefeld L, Hammerschmidt K, Poggi G, Seelbach A, et al. Hypersocial behavior and biological redundancy in mice with reduced expression of PSD95 or PSD93. Behav Brain Res. 2018;352:35–45.
pubmed: 28189758 doi: 10.1016/j.bbr.2017.02.011
Netrakanti PR, Cooper BH, Dere E, Poggi G, Winkler D, Brose N, et al. Fast cerebellar reflex circuitry requires synaptic vesicle priming by munc13-3. Cerebellum. 2015;14:264–83.
pubmed: 25617111 pmcid: 4441738 doi: 10.1007/s12311-015-0645-0
Wakhloo D, Scharkowski F, Curto Y, Javed Butt U, Bansal V, Steixner-Kumar AA, et al. Functional hypoxia drives neuroplasticity and neurogenesis via brain erythropoietin. Nat Commun. 2020;11:1–12.
Liebetanz D, Baier PC, Paulus W, Meuer K, Bahr M, Weishaupt JH. A highly sensitive automated complex running wheel test to detect latent motor deficits in the mouse MPTP model of Parkinson’s disease. Exp Neurol. 2007;205:207–13.
pubmed: 17341420 doi: 10.1016/j.expneurol.2007.01.030
McKenzie IA, Ohayon D, Li H, de Faria JP, Emery B, Tohyama K, et al. Motor skill learning requires active central myelination. Science. 2014;346:318–22.
pubmed: 25324381 pmcid: 6324726 doi: 10.1126/science.1254960
Berghoff SA, Duking T, Spieth L, Winchenbach J, Stumpf SK, Gerndt N, et al. Blood-brain barrier hyperpermeability precedes demyelination in the cuprizone model. Acta Neuropathol Commun. 2017;5:1–13.
Schindelin J, Arganda-Carreras I, Frise E, Kaynig V, Longair M, Pietzsch T, et al. Fiji: an open-source platform for biological-image analysis. Nat Methods. 2012;9:676–82.
pubmed: 22743772 doi: 10.1038/nmeth.2019
R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2020.
Kassambara A. rstatix: pipe-friendly framework for basic statistical tests. 0.7.0 ed 2021.
Brockschnieder D, Lappe-Siefke C, Goebbels S, Boesl MR, Nave KA, Riethmacher D. Cell depletion due to diphtheria toxin fragment A after Cre-mediated recombination. Mol Cell Biol. 2004;24:7636–42.
pubmed: 15314171 pmcid: 506983 doi: 10.1128/MCB.24.17.7636-7642.2004
Radyushkin K, El-Kordi A, Boretius S, Castaneda S, Ronnenberg A, Reim K, et al. Complexin2 null mutation requires a ‘second hit’ for induction of phenotypic changes relevant to schizophrenia. Genes Brain Behav. 2010;9:592–602.
pubmed: 20412316
Morris RGM. Spatial localization does not require the presence of local cues. Learn Motiv. 1981;12:239–60.
doi: 10.1016/0023-9690(81)90020-5
Braff D, Stone C, Callaway E, Geyer M, Glick I, Bali L. Prestimulus effects on human startle reflex in normals and schizophrenics. Psychophysiology. 1978;15:339–43.
pubmed: 693742 doi: 10.1111/j.1469-8986.1978.tb01390.x
Fendt M, Koch M. Translational value of startle modulations. Cell Tissue Res. 2013;354:287–95.
pubmed: 23525740 doi: 10.1007/s00441-013-1599-5
Kumari V, Das M, Zachariah E, Ettinger U, Sharma T. Reduced prepulse inhibition in unaffected siblings of schizophrenia patients. Psychophysiology. 2005;42:588–94.
pubmed: 16176381 doi: 10.1111/j.1469-8986.2005.00346.x
Poggi G, Boretius S, Möbius W, Moschny N, Baudewig J, Ruhwedel T, et al. Cortical network dysfunction caused by a subtle defect of myelination. Glia. 2016;64:2025–40.
pubmed: 27470661 pmcid: 5129527 doi: 10.1002/glia.23039
Ehrenreich H, Wilke J, Steixner-Kumar AA. Spontaneous serum autoantibody fluctuations: To be or not to be. Mol Psychiatry. 2020. https://doi.org/10.1038/s41380-020-00883-4 .
Ding Y, Zhou Z, Chen J, Peng Y, Wang H, Qiu W, et al. Anti-NMDAR encephalitis induced in mice by active immunization with a peptide from the amino-terminal domain of the GluN1 subunit. Journal of Neuroinflammation. 2021;18:1–10.
Yue W, Caldwell S, Risbrough V, Powell S, Zhou X. Chronic Presence of Blood Circulating Anti-NMDAR1 Autoantibodies Impairs Cognitive Function in Mice. bioRxiv. 2021. https://doi.org/10.1101/2021.04.22.440976 .
Glatigny S, Bettelli E. Experimental autoimmune encephalomyelitis (EAE) as animal models of multiple sclerosis (MS). Cold Spring Harb Perspect Med. 2018;8:1–19.
doi: 10.1101/cshperspect.a028977
Gold R, Linington C, Lassmann H. Understanding pathogenesis and therapy of multiple sclerosis via animal models: 70 years of merits and culprits in experimental autoimmune encephalomyelitis research. Brain 2006;129:1953–71.
pubmed: 16632554 doi: 10.1093/brain/awl075
Comabella M, Martin R. Genomics in multiple sclerosis—current state and future directions. J Neuroimmunol. 2007;187:1–8.
pubmed: 17400297 doi: 10.1016/j.jneuroim.2007.02.009
Gleichman AJ, Spruce LA, Dalmau J, Seeholzer SH, Lynch DR. Anti-NMDA receptor encephalitis antibody binding is dependent on amino acid identity of a small region within the GluN1 amino terminal domain. J Neurosci. 2012;32:11082–94.
pubmed: 22875940 pmcid: 3430387 doi: 10.1523/JNEUROSCI.0064-12.2012
Gandy KAO, Zhang J, Nagarkatti P, Nagarkatti M. The role of gut microbiota in shaping the relapse-remitting and chronic-progressive forms of multiple sclerosis in mouse models. Sci Rep. 2019;9:6923.
pubmed: 31061496 pmcid: 6502871 doi: 10.1038/s41598-019-43356-7
Castillo-Gómez E, Oliveira B, Tapken D, Bertrand S, Klein-Schmidt C, Pan H, et al. All naturally occurring autoantibodies against the NMDA receptor subunit NR1 have pathogenic potential irrespective of epitope and immunoglobulin class. Mol Psychiatry. 2017;22:1776–84.
pubmed: 27502473 doi: 10.1038/mp.2016.125
Zhang J, Jacobi AM, Wang T, Berlin R, Volpe BT, Diamond B. Polyreactive autoantibodies in systemic lupus erythematosus have pathogenic potential. J Autoimmun. 2009;33:270–4.
pubmed: 19398190 pmcid: 2783480 doi: 10.1016/j.jaut.2009.03.011

Auteurs

Justus B H Wilke (JBH)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Martin Hindermann (M)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Stefan A Berghoff (SA)

Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Svenja Zihsler (S)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Sahab Arinrad (S)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Anja Ronnenberg (A)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Nadine Barnkothe (N)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Agnes A Steixner-Kumar (AA)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Stefan Röglin (S)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Winfried Stöcker (W)

Institute for Experimental Immunology, affiliated to Euroimmun, Lübeck, Germany.

Michael Hollmann (M)

Department of Biochemistry I-Receptor Biochemistry, Ruhr University, Bochum, Germany.

Klaus-Armin Nave (KA)

Department of Neurogenetics, Max Planck Institute of Experimental Medicine, Göttingen, Germany.

Fred Lühder (F)

Institute for Neuroimmunology and Multiple Sclerosis Research, University Medical Center Göttingen, Göttingen, Germany.

Hannelore Ehrenreich (H)

Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany. ehrenreich@em.mpg.de.

Articles similaires

Robotic Surgical Procedures Animals Humans Telemedicine Models, Animal

Odour generalisation and detection dog training.

Lyn Caldicott, Thomas W Pike, Helen E Zulch et al.
1.00
Animals Odorants Dogs Generalization, Psychological Smell
Animals TOR Serine-Threonine Kinases Colorectal Neoplasms Colitis Mice
Animals Tail Swine Behavior, Animal Animal Husbandry

Classifications MeSH