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Early autoimmunity and outcome in virus encephalitis: a retrospective study based on tissue-based assay.
Liu, Ding; Lin, Pei-Hao; Li, Hui-Lu; Yang, Jie; You, Yong; Yang, Xiao; Jiang, Li-Hong; Ma, Cai-Yu; Xu, Lu-Fen; Zhang, Qing-Xia; Liao, Sha; Chen, Han; Yue, Jia-Jia; Lu, Yu-Ying; Lian, Chun; Liu, Yin; Wang, Zhan-Hang; Ye, Jin-Long; Qiu, Wei; Shu, Ya-Qing; Wang, Hai-Yang; Liu, Hong-Li; Wang, Yue; Duan, Chun-Mei; Yang, Huan; Wu, Xiu-Ling; Zhang, Lu; Feng, Hui-Yu; Chen, Huan; Zhou, Hou-Shi; Xu, Qian-Hui; Zhao, Gui-Xian; Ou, Teng-Fei; Wang, Jin-Liang; Lu, Yu-Hua; Mao, Zhi-Feng; Gao, Cong; Guo, Jun; Zhang, Hong-Ya; Chen, Sheng; Li, Jing; Long, You-Ming.
Afiliación
  • Liu D; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Lin PH; Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Li HL; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Yang J; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • You Y; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Yang X; Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.
  • Jiang LH; Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
  • Ma CY; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Xu LF; Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Zhang QX; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Liao S; Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Chen H; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Yue JJ; Department of Neurology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Lu YY; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Lian C; Key Laboratory of Microbial Molecular Biology of Hunan Province, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China.
  • Liu Y; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Wang ZH; Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Ye JL; Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, China.
  • Qiu W; Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, China.
  • Shu YQ; Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
  • Wang HY; Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
  • Liu HL; Department of Neurology, Jining No. 1 People's Hospital, Jining, China.
  • Wang Y; Department of Neurology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
  • Duan CM; Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China.
  • Yang H; Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqing, China.
  • Wu XL; Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China.
  • Zhang L; Department of Neurology, Tangshan Gongren Hospital, Tangshan, Hebei, China.
  • Feng HY; Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
  • Chen H; Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
  • Zhou HS; Department of Neurology, Shantou Central Hospital, Shantou, Guangdong, China.
  • Xu QH; Department of Neurology, Shantou Central Hospital, Shantou, Guangdong, China.
  • Zhao GX; Department of Neurology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.
  • Ou TF; Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China.
  • Wang JL; Department of Neurology, The Second People's Hospital of Foshan, Foshan, Guangdong, China.
  • Lu YH; Department of Neurology, The Second People's Hospital of Foshan, Foshan, Guangdong, China.
  • Mao ZF; Department of Neurology, People's Hospital of Chongqing Banan District, Chongqing, China.
  • Gao C; Neurimmunology Group, Institution of Kingmed, Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Guo J; Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and The Ministry of Education of China, Institute of Neuroscience, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
  • Zhang HY; Department of Neurology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
  • Chen S; Department of Neurology, Shenzhen University General Hospital, Shenzhen, Guangdong, China.
  • Li J; Department of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Long YM; Department of Neurology, Xiangya Hospital of Central South University, Changsha, Hunan, China youminglong@126.com lijing.neurology@aliyun.com.
J Neurol Neurosurg Psychiatry ; 94(8): 605-613, 2023 08.
Article en En | MEDLINE | ID: mdl-37225405
ABSTRACT
To explore the autoimmune response and outcome in the central nervous system (CNS) at the onset of viral infection and correlation between autoantibodies and viruses.

METHODS:

A retrospective observational study was conducted in 121 patients (2016-2021) with a CNS viral infection confirmed via cerebrospinal fluid (CSF) next-generation sequencing (cohort A). Their clinical information was analysed and CSF samples were screened for autoantibodies against monkey cerebellum by tissue-based assay. In situ hybridisation was used to detect Epstein-Barr virus (EBV) in brain tissue of 8 patients with glial fibrillar acidic protein (GFAP)-IgG and nasopharyngeal carcinoma tissue of 2 patients with GFAP-IgG as control (cohort B).

RESULTS:

Among cohort A (malefemale=7942; median age 42 (14-78) years old), 61 (50.4%) participants had detectable autoantibodies in CSF. Compared with other viruses, EBV increased the odds of having GFAP-IgG (OR 18.22, 95% CI 6.54 to 50.77, p<0.001). In cohort B, EBV was found in the brain tissue from two of eight (25.0%) patients with GFAP-IgG. Autoantibody-positive patients had a higher CSF protein level (median 1126.00 (281.00-5352.00) vs 700.00 (76.70-2899.00), p<0.001), lower CSF chloride level (mean 119.80±6.24 vs 122.84±5.26, p=0.005), lower ratios of CSF-glucose/serum-glucose (median 0.50[0.13-0.94] vs 0.60[0.26-1.23], p=0.003), more meningitis (26/61 (42.6%) vs 12/60 (20.0%), p=0.007) and higher follow-up modified Rankin Scale scores (1 (0-6) vs 0 (0-3), p=0.037) compared with antibody-negative patients. A Kaplan-Meier analysis revealed that autoantibody-positive patients experienced significantly worse outcomes (p=0.031).

CONCLUSIONS:

Autoimmune responses are found at the onset of viral encephalitis. EBV in the CNS increases the risk for autoimmunity to GFAP.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Infecciones por Virus de Epstein-Barr / Encefalitis Tipo de estudio: Observational_studies / Risk_factors_studies Idioma: En Revista: J Neurol Neurosurg Psychiatry Año: 2023 Tipo del documento: Article
Texto completo
Imprimir
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PubMed Links
Buscar en Google

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Infecciones por Virus de Epstein-Barr / Encefalitis Tipo de estudio: Observational_studies / Risk_factors_studies Idioma: En Revista: J Neurol Neurosurg Psychiatry Año: 2023 Tipo del documento: Article