Antibodies and Brain Disease A Convergence of Immunology and Physiology 英文参考文献.docVIP

Perspectives Antibodies and Brain Disease: A Convergence of Immunology and Physiology Betty Diamond , Bruce T. Volpe * I ncreasingly, patients with systemic lupus erythematosus (SLE) are recognized to have central nervous Glossary A New Technique to Study Neuronal Damage D/E W D/E Y S/G: A 5–amino acid In a new study in PLoS Medicine, consensus sequence recognized by lupus antibodies and present in the NR2A and NR2B subunits of the NMDA receptor. system (CNS) manifestations. Overt in?ammation in the CNS is rare, but impairment of cognition or mood disturbance is common. Treatment of in?ammation is directed at the underlying autoimmune disorder; treatment of other manifestations, including mood disorder, often focuses on symptom alleviation. Cognitive impairment in particular appears to be progressive and unrelated to disease activity, and, at the present time, untreatable. One interesting aspect of neuropsychiatric lupus is that symptoms may remit as well as progress. With no known pathophysiology for the cognitive impairment or mood disturbance seen in SLE, and no ability to track the dynamic state of either of these symptom complexes, it has been dif?cult to develop a meaningful classi?cation of neuropsychiatric SLE or a mechanistic understanding of these aspects of the disease process. There is possible mechanistic Emmer and colleagues attempted to test whether the presence of the anti- NMDAR antibody correlates with brain abnormality [15]. The abnormality was assessed by an emerging quantitative magnetic resonance imaging technique—diffusion weighted images (DWIs) and the use of the apparent diffusion coef?cient (ADC). DWIs and the ADC offer the promise of a quantitative physiological measure of cellular integrity from magnetic resonance images. ADCs measure the movement of water molecules that are systematically altered in DWEYS peptide: The antigen used in enzyme-linked immunosorbent assays to look for anti-NMDA receptor antibodies. Epitope: An antigenic det