Hello from the Other Side: How Autoantibodies Circumvent the Blood–Brain Barrier in Autoimmune Encephalitis
When immune cells and autoantibodies impact brain functioning.
Antibodies against neuronal receptors and synaptic proteins are associated with autoimmune encephalopathies (AE) that produce movement and psychiatric disorders. The authors of this publication review proposed triggers and routes of how antibodies and immune cells enter the central nervous system (CNS). Cutforth et al discuss promising future therapeutic strategies that may preserve or restore the blood-brain barrier (BBB) function and limit immune cell and autoantibody infiltration into the CNS.1
- Pathological antibodies may enhance BBB permeability and promote production of inflammatory cytokines, thus enabling immune cells to impact the brain.
- A re-exposure of the immune system to brain antigens or an external trigger that causes production of cross-reactive autoantibodies is a crucial step in CNS autoimmune disease.
- A majority of viral triggers (of AE) are believed to create a pro-inflammatory state that “primes” the immune system to become overactive and lead to an autoimmune response against the CNS. Evidence suggests that microglial and CNS resident immune cells become overactive, Th1 cytokines are elevated during viral encephalitis and IL-6 (essential for development of TH17 cells) is escalated in autoimmune disorders.
What is the Cunningham Panel™ of tests?
The Cunningham Panel™ measures the level of brain and CNS target-specific autoantibodies associated with various neuropsychiatric disorders and their ability to stimulate and trigger abnormal neurologic and psychiatric behaviors. Elevated levels of these antibodies aid in identifying an autoimmune etiology where a patient’s symptoms may be due to an infection-induced autoimmune response.
Platt MP, Agalliu D, Cutforth T. Hello from the Other Side: How Autoantibodies Circumvent the Blood-Brain Barrier in Autoimmune Encephalitis. Frontiers in Immunology (2017) 8:442. doi: 10.3389/fimmu.2017.00442
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Interested in learning more about autoimmune encephalopathies and the Cunningham Panel™? We have compiled a list of journal articles that may be helpful, along with additional resources.