PhD Scientific Days 2018

Budapest, April 19–20, 2018

Screening for anti-NMDAR antibodies in the serum of patients with first episode psychosis

Herman, Levente

Dr. Levente Hermán1, Dr. Réka Ildikó Zsigmond2, Dr. János Réthelyi3
1,2,3 Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest

Language of the presentation

Hungarian

Text of the abstract

Introduction
Anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis is an autoimmune limbic encephalitis, where psychiatric symptoms are often dominant in the initial phase. These patients are usually treated in psychiatric wards, due to first episode psychosis (FEP). The antibodies responsible for the symptoms, can be identified from the patients’ sera. It is possible that autoimmune antibodies, which are not yet known, play a role in FEP, similarly to anti-NMDAR antibodies.

Aims
The aim of our study was to screen patients with FEP for anti-NMDAR antibodies. We also wanted to check whether there are any other potentially pathogenic antibodies, which are not yet known, but could be responsible for the symptoms.

Method
We have recruited 24 patients with FEP (with symptoms of schizophrenia), all of them were treated at Semmelweis University, Department of Psychiatry. The patients’ blood samples were centrifuged, after which serum was separated from whole blood. Serum samples were then tested with EUROIMMUN immune fluorescent assays for anti-NMDAR antibodies. A different, non-specific method was also used to test anti-brain antibody activity on monkey-cerebellum and rat-hippocampus to show possibly relevant (but not yet known) antibodies. Further differentiation of this non-specific activity was not part of our current study. Control participants have not yet been involved, although this is planned in the next phase of this study.

Results
None of the 24 patient had anti-NMDAR antibodies, which is probably because of the low incidence rate of the disease. 9 of the patients’ serum showed positive reaction of the neuroendothelium (4 strong, 4 moderate and 1 mild). 5 other samples showed other types of non-specific activity-patterns.

Conclusion
However none of the serum samples of the 24 patients proved positive for anti-NMDAR antibodies, a significant rate of them showed certain activity patterns on the non-specific immune fluorescent assays. We plan to test healthy volunteers as control group in the future.

Data of the presenter

Doctoral school: Mental health sciences
Program: 01 Psychiatry
Supervisor: János Réthelyi
E-mail adress: herman.levente@med.semmelweis-univ.hu