Preexisting Serum Autoantibodies Against the NMDAR Subunit NR1 Modulate Evolution of Lesion Size in Acute Ischemic Stroke

Stroke; a Journal of Cerebral Circulation
M ZercheH Ehrenreich

Abstract

Recently, we reported high seroprevalence (age-dependent up to >19%) of N-methyl-d-aspartate-receptor subunit NR1 (NMDAR1) autoantibodies in both healthy and neuropsychiatrically ill subjects (N=4236). Neuropsychiatric syndrome relevance was restricted to individuals with compromised blood-brain barrier, for example, apolipoprotein E4 (APOE4) carrier status, both clinically and experimentally. We now hypothesized that these autoantibodies may upon stroke be protective in individuals with hitherto intact blood-brain barrier, but harmful for subjects with chronically compromised blood-brain barrier. Of 464 patients admitted with acute ischemic stroke in the middle cerebral artery territory, blood for NMDAR1 autoantibody measurements and APOE4 carrier status as indicator of a preexisting leaky blood-brain barrier was collected within 3 to 5 hours after stroke. Evolution of lesion size (delta day 7-1) in diffusion-weighted magnetic resonance imaging was primary outcome parameter. In subgroups, NMDAR1 autoantibody measurements were repeated on days 2 and 7. Of all 464 patients, 21.6% were NMDAR1 autoantibody-positive (immunoglobulin M, A, or G) and 21% were APOE4 carriers. Patients with magnetic resonance imaging data available on d...Continue Reading

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Citations

Oct 28, 2015·Annals of Neurology·Esther Castillo-GomezHannelore Ehrenreich
Jan 26, 2016·Nature Reviews. Neuroscience·Sarah J CrispAngela Vincent
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Sep 21, 2019·Evidence-based Mental Health·Sophie Behrman, Belinda Lennox
Sep 9, 2020·Stroke; a Journal of Cerebral Circulation·Mitchell S V ElkindMarion S Buckwalter
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Jul 17, 2021·Frontiers in Immunology·Raquel Ruiz-GarcíaEugenia Martinez-Hernandez

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