抗N-甲基-D-天门冬氨酸受体脑炎合并卵巢畸胎瘤的发病机制及治疗研究进展
Research Advances in the Pathogenesis and Treatment of Ovarian Teratoma-Related Anti-NMDAR Encephalitis
DOI: 10.12677/ACM.2022.124393, PDF,   
作者: 彭慧敏, 程 敏*：重庆医科大学附属儿童医院神经内科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室，重庆
关键词: 畸胎瘤；抗NMDAR脑炎；流行病学；发病机制；Teratoma； Anti-NMDAR Encephalitis； Epidemiology； Pathogenesis
摘要: 抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor, NMDAR)脑炎是一种免疫介导的神经炎性疾病。其特征是复杂的神经精神综合征和存在针对NMDAR的GluN1亚基(glutamate receptor 1)的脑脊液抗体。近年来越来越多报道显示畸胎瘤与抗NMADR脑炎关联密切，且畸胎瘤相关的抗NMADR脑炎，疾病进展快，病情重，早期给予免疫治疗及手术治疗可改善预后。因此本文就抗NMADR脑炎合并卵巢畸胎瘤的流行病学、发病机制、诊治进展进行讨论，以期为医生及研究者们提供参考。
Abstract: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated inflammatory disease, which is characterized by a complex neuropsychiatric syndrome and the presence of cerebrospinal fluid antibodies against the GluN1 subunit of the NMDAR. Recently, more and more reports have shown that teratoma is closely related to anti-NMADR encephalitis, and ovarian teratoma-related anti-NMDAR encephalitis is more likely to have a rapid progression and more severe. Most patients can get a good prognosis after early immunotherapy and surgery. This article reviews the epidemiology, pathogenesis, diagnosis and treatments of the disease in order to provide reference for doctors and researchers.
文章引用：彭慧敏, 程敏. 抗N-甲基-D-天门冬氨酸受体脑炎合并卵巢畸胎瘤的发病机制及治疗研究进展[J]. 临床医学进展, 2022, 12(4): 2735-2739. https://doi.org/10.12677/ACM.2022.124393

参考文献

[1] Graus, F. and Dalmau, J. (2012) Paraneoplastic Neurological Syndromes. Current Opinion in Neurology, 25, 795-801. [Google Scholar] [CrossRef] 
[2] Dalmau, J., Tüzün, E., Wu, H.Y., et al. (2007) Paraneoplastic Anti-N-methyl-D-aspartate Receptor Encephalitis Associated with Ovarian Teratoma. Annals of Neurology, 61, 25-36. [Google Scholar] [CrossRef] [PubMed]
[3] Graus, F., Titulaer, M.J., Balu, R., Benseler, S., Bien, C.G., Cellucci, T., Cortese, I. and Dalmau, J. (2016) A Clinical Approach to Diagnosis of Autoimmune Encephalitis. The Lancet Neurology, 15, 391-404. [Google Scholar] [CrossRef] 
[4] 中华医学会神经病学分会. 中国自身免疫性脑炎诊治专家共识[J]. 中华神经科杂志, 2017, 50(2): 91-98.
[5] Patel, K.H., Chowdhury, Y., Shetty, M., Uppin, V., Madaj, P., Salifu, M.O., Youssef, M., Henglein, V.L. and McFaralne, S.I. (2020) Anti-N-methyl-d-aspartate Receptor Encephalitis Related Sinus Node Dysfunction and the Lock-Step Phenomenon. American Journal of Medical Case Reports, 8, 503-507. [Google Scholar] [CrossRef] [PubMed]
[6] Titulaer, M.J., McCracken, L., Gabilondo, I., et al. (2013) Treatment and Prognostic Factors for Long-Term Outcome in Patients with Anti-NMDA Receptor Encephalitis: An Observational Cohort Study. The Lancet Neurology, 12, 157-165. [Google Scholar] [CrossRef] 
[7] Florance, N.R., Davis, R.L. and Dalmau, J. (2009) Anti-N-methyl-D-aspartate Receptor (NMDAR) Encephalitis in Children and Adolescents. Annals of Neurology, 66, 11-18. [Google Scholar] [CrossRef] [PubMed]
[8] Yaguchi, H., Tsuji, T., Yabe, I., Hirayama, E., Nomura, T., Ohashi, I., Mito, Y., Tanaka, K. and Tajima, Y. (2020) Incidence of Anti-NMDAR Encephalitis in Patients Undergoing Resection of Ovarian Teratoma in a Single Institution. Journal of the Neurological Sciences, 409, Article ID: 116608. [Google Scholar] [CrossRef] [PubMed]
[9] 蒋慧云, 黄珊瑜, 李小毛. 单中心卵巢畸胎瘤患者中合并抗N-甲基-D-天冬氨酸受体脑炎的比例调查及临床特征分析[J]. 新医学, 2021, 52(7): 541-544.
[10] Dalmau, J., Armangue, T. and Graus, F. (2019) An Update on Anti-NMDA Receptor Encephalitis for Neurologists and Psychiatrists: Mechanisms and Models. The Lancet Neurology, 18, 1045-1057. [Google Scholar] [CrossRef] 
[11] Chefdeville, A., Treilleux, I., Mayeur, M.E., Couillault, C., Picard, G., Bost, C., Mokhtari, K., Vasiljevic, A., Meyronet, D., Rogemond, V., Psimaras, D., Dubois, B., Honnorat, J. and Desestret, V. (2019) Immunopathological Characterization of Ovarian Teratomas Associated with Anti-N-methyl-D-aspartate Receptor Encephalitis. Acta Neuropathologica Communications, 7, 38. [Google Scholar] [CrossRef] [PubMed]
[12] Clark, R.M., Lynch, M.P., Kolp, R., Zukerberg, L.R., Growdon, W.B. and Rueda, B.R. (2014) The N-methyl-D-aspartate Receptor, a Precursor to N-methyl-D-aspartate Receptor Encephalitis, Is Found in the Squamous Tissue of Ovarian Teratomas. International Journal of Gynecological Pathology, 33, 598-606. [Google Scholar] [CrossRef] 
[13] Reiber, H. and Peter, J.B. (2001) Cerebrospinal Fluid Analysis: Disease-Related Data Patterns and Evaluation Programs. Journal of the Neurological Sciences, 184, 101-122. [Google Scholar] [CrossRef] 
[14] Armangue, T., Spatola, M. and Dalmau, J. (2018) Frequency, Symptoms, Risk Factors, and Outcomes of Autoimmune Encephalitis after Herpes Simplex Encephalitis: A Prospective Observational Study and Retrospective Analysis. The Lancet Neurology, 17, 760-772.
[15] Malviya, M., Barman, S., Golombeck, K.S., Planaguma, J., Mannara, F., Strutz-Seebohm, N., Wrzos, C., Demir, F., Baksmeier, C., Steckel, J., Falk, K.K., Gross, C.C., Kovac, S., Bönte, K., Johnen, A., Wandinger, K.P., Marrtin-Garcia, E., Becker, A.J., Elger, C.E., Klöcker, N., Wiendl, H., Meuth, S.G., Hartung, H.P., Seebohm, G., Leypoldt, F., Maldonado, R., Stadelmann, C., Dalmau, J., Melzer, N. and Goebels, N. (2017) NMDAR Encephalitis: Passive Transfer from Man to Mouse by a Recombinant Antibody. Annals of Clinical and Translational Neurology, 4, 768-783. [Google Scholar] [CrossRef] [PubMed]
[16] Jones, B.E., Tovar, K.R., Goehring, A., Jalali-Yazdi, F., Okada, N.J., Gouaux, E. and Westbrook, G.L. (2019) Autoimmune Receptor Encephalitis in Mice Induced by Active Immunization with Conformationally Stabilized Holoreceptors. Science Translational Medicine, 11, eaaw0044. [Google Scholar] [CrossRef] [PubMed]
[17] Titulaer, M.J., Soffietti, R., Dalmau, J., Gilhus, N.E., Giometto, B., Graus, F., Grisold, W., Honnorat, J., Sillevis Smitt, P.A., Tanasescu, R., Vedeler, C.A., Voltz, R., Verschuuren, J.J. and European Federation of Neurological Societies (2011) Screening for Tumours in Paraneoplastic Syndromes: Report of an EFNS Task Force. European Journal of Neurology, 18, 19-e3. [Google Scholar] [CrossRef] [PubMed]
[18] 李小毛. 重视引发致死性抗NMDAR脑炎的畸胎瘤诊治[J]. 中国医师杂志, 2019, 21(2): 161-163.

为你推荐