What is it about?
The manuscript has disclosed that autoantibodies to NMDA receptors detected by cell-based assay (anti-NR1/NR2) in patients with NMDA receptor encephalitis are totally different from those against the linear epitope in NR2 subunit (anti-NR2) found in patients with NPSLE. Moreover, it was found that the prevalence of anti-NR1/NR2 is extremely low in NPSLE. Thus, the manuscript has demonstrated the difference of epitopes and mechanisms of expression of these 2 autoantibodies in NMDA receptors.
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Why is it important?
For diagnosis of NPSLE, cell-based assay should not be used. Instead, ELISA using peptide containing NR2A/NR2B lineage epitope is appropriate.
Perspectives
Differences in the epitopes in anti-NMDA receptor encephalitis and those in NPSLE would result from different mechanism of generation of these antibodies. Further studies to clarify this point would be interesting.
Shunsei Hirohata
Read the Original
This page is a summary of: Differential expression of antibodies to NMDA receptor in anti-NMDA receptor encephalitis and in neuropsychiatric systemic lupus erythematosus, Lupus Science & Medicine, November 2019, BMJ,
DOI: 10.1136/lupus-2019-000359.
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