Distinct immunoreactivity pattern to Bacillus mannanilyticus in a subgroup of anti-NMDA receptor encephalitis

Yong Won Shin, Soon Tae Lee, Young Sook Kim, Dohyun Han, Yuichi Nogi, Kon Chu, Sang Kun Lee

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Abstract

Over half of anti-NMDA receptor encephalitis (NMDARE) is unrelated to etiologies such as teratomas or herpes simplex encephalitis. Bacillus mannanilyticus nonribosomal peptide synthetase (NRPS) shares a protein sequence with GluN1. After confirming the anti-NRPS antibody immunoreactivity in an index patient by liquid chromatography-tandem mass spectrometry (LC-MS/MS), we identified 24/57 (42%) patients with similar immunoreactivity patterns by western blotting. These patients mostly (20/24 [83%]) did not have ovarian teratomas, had fewer medial temporal (2/24 [8%]) and any (5/24 [21%]) brain lesions and less pleocytosis (13/24 [54%]). These results identified an anti-NMDARE subgroup with a distinct immunoreactivity pattern, which needs further investigation.

Original languageEnglish
Article number577215
JournalJournal of Neuroimmunology
Volume342
DOIs
StatePublished - 15 May 2020

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Keywords

  • Anti-NMDA receptor encephalitis
  • Bacillus mannanilyticus
  • Nonribosomal peptide synthetase

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