抗NMDAR脑炎中B细胞相关免疫病理机制与治疗进展  

B Cell Associated Immunopathological Mechanisms in Anti-NMDAR Encephalitis and Therapeutic Advances

作　　者：杨素格 韩松 常忠正 徐营营[1] 周晓艳[1] 魏艳[1] 程玲[1] 王允[1] YANG Suge;HAN Song;CHANG Zhongzheng;XU Yingying;ZHOU Xiaoyan;WEI Yan;CHENG Ling;WANG Yun(Department of Neurology,the Second Hospital of Shandong University,Jinan 250033,China;Department of General Practice,the Second Hospital of Shandong University,Jinan 250033,China)

机构地区：[1]山东大学第二医院神经内科,济南250033 [2]山东大学第二医院全科,济南250033

出　　处：《医学综述》2024年第9期1025-1030,共6页Medical Recapitulate

基　　金：山东省自然科学基金(ZR2023MH256);新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202210)。

摘　　要：抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是自身免疫性脑炎中最常见的类型之一,其发病机制与B细胞介导的体液免疫反应产生的抗NMDAR抗体有关。抗NMDAR脑炎患者B细胞表面受体互补决定区3存在特异性核酸排列顺序。CXC趋化因子配体13、白细胞介素-6、白细胞介素-17在B细胞迁移和浸润过程中起重要作用。目前,临床已开始使用利妥昔单抗和托珠单抗治疗抗NMDAR脑炎。未来,深入研究抗NMDAR脑炎中B细胞成熟和克隆分化的分子机制,有助于寻找抗NMDAR脑炎的生物标志物,为疾病的早期诊断和靶向治疗提供理论支持。Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis is one of the most common types of autoimmune encephalitis and its pathogenesis is associated with anti-NMDAR antibodies generated by the humoral immune response mediated by B cells.Specific nucleic acid sequence exists in B cell surface receptor complementarity determination region 3 in anti-NMDAR encephalitis patients.The chemokine(C-X-C motif)ligand 13,interleukin-6 and interleukin-17 play important roles in B cell migration and infiltration.At present,rituximab and tolizumab are used clinically to treat anti-NMDAR encephalitis.In the future,in-depth studies on the molecular mechanisms of B cell maturation and clonal differentiation in anti-NMDAR encephalitis will help to find biomarkers for anti-NMDAR encephalitis and provide theoretical support for the early diagnosis and targeted therapy.

关 键 词：抗N-甲基-D-天冬氨酸受体脑炎 B细胞 B细胞库 细胞因子 单克隆抗体 

分 类 号：R741.02[医药卫生—神经病学与精神病学]