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. 2022 Sep 28:5:100167.
doi: 10.1016/j.jtauto.2022.100167. eCollection 2022.

Increased T- and B-cells associated with the phenotype of autoimmune limbic encephalitis with mainly memory dysfunction

Niels Hansen  1   2 , Guido Widman  1 , Demet Önder  1 , Kerstin Schwing  1 , Pitshaporn Leelaarporn  1 , Indra Prusseit  3 , Randi von Wrede  1 , Rainer Surges  1   4 , Albert J Becker  3 , Juri-Alexander Witt  1 , Christian E Elger  1 , Christoph Helmstaedter  1
Affiliations

Increased T- and B-cells associated with the phenotype of autoimmune limbic encephalitis with mainly memory dysfunction

Niels Hansen et al. J Transl Autoimmun. .

Abstract

Background: Our goal is to investigate the autoantibodies' presence and immune cells in the bioprobes of autoimmune encephalitis (AE) patients with distinct phenotypes as a promising target in AE.

Methods: We retrospectively analyzed immune cells via flow cytometry, serum and cerebrospinal fluid (CSF) autoantibodies, electroencephalography, magnetic resonance imaging in 94 AE patients with suspected temporal lobe epilepsy and classified neuropsychological phenotypes according to their occurrence.

Results: We detected different phenotypes in 94 AE patients [10.6% with isolated memory dysfunction (MEM), 11.7% with mood-dysfunction, 12.7% with mood and memory dysfunction, 13.8% with memory and attention dysfunction, 18.1% with memory, mood and attention disturbances and 20.2% with no mood, memory or attention dysfunction]. We did discern a relevant association of phenotypes and CSF antibody-positivity on CSF CD4+ T-cells, CD8+T-cells and HLADR + CD8+T-cells in our patients with MEM presenting elevated CD8+T-cells and HLADR + CD8+T-cells. Furthermore, CSF CD19+B-cells differed significantly between phenotypes in patients with MEM.

Discussion: Taken together, the phenotypes in combination with CSF antibody-positivity are biomarkers for stratifying patients. Furthermore, our results confirm the role of CD4+ T-cells, CD8+T-cells and CD19+B-cells in AE patients with a memory dysfunction, providing insights into AE pathogenesis. Our preliminary results should be confirmed by larger-scale investigations.

Keywords: Autoantibodies; Autoimmune encephalitis; Immune cells; Neuropsychology; Phenotype; Verbal memory.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Elevated CD4+ T-cells, CD8+T cells and CD19+ B-cells are associated with the phenotype of autoimmune encephalitis with mainly memory impairment. In A the distribution of phenotypes among our cohort of patients with autoimmune limbic encephalitis is shown. In B elevated HLADR + CD8+ T-cells, in C ascended CD19+ B-cells, in D increased CD8+ T-cells and in E elevated CD4+ T-cells are shown in MEM phenotype. The phenotype is a relevant factor determining the differences between HLADR + CD8+ T-cells in B, CD19+ B-cells in C, CD8+ T-cells in D and CD4+ T-cells in E among phenotypes. *p < 0.005 two factorial ANOVA. Abbreviations: MEM = phenotype with memory dysfunction, PSY = phenotype with mood dysfunction, MEM + PSY = phenotype with mood and memory dysfunction, MEM + ATT = phenotype of memory and attentional dysfunction, MEM + PSY + ATT = phenotype of memory, attentional-executive and mood dysfunction, MEM-PSY-ATT- = phenotype without affection of memory, mood and attentional-executive functions.
See this image and copyright information in PMC

References

    1. Graus F., Titulaer M.J., Balu R., Benseler S., Bien C.G., Celluci T., Cortese I., Dale R.C., Gelfand J.M., Geschwind M., Glaser C.A., Honnorat J., Höftberger R., Iizuka T., Irani S.R., Lancaster E., Leypoldt F., Prüss H., Rae-Grant A., Reindl M., Rosenfeld M.R., Rostásy K., Saiz A., Venkatesan A., Vincent A., Wandinger K.P., Waters P., Dalmau J. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15:391–404. doi: 10.1016/S1474-4422(15)00401-9. - DOI - PMC - PubMed
    1. Kelleher E., Barry H., Cotter D.R., Corvin A., Murphy K.C. Autoantibodies and psychosis. Curr Top Behav Neurosci. 2019;44:85–123. doi: 10.1007/7854_2019_90. - DOI - PubMed
    1. Witt J.A., Helmstaedter C. Neuropsychological evaluation in limbic encephalitis. Brain Sci. 2021;11:576. doi: 10.3390/brainsci11050576. - DOI - PMC - PubMed
    1. Irani S.R., Vincent A. Voltage-gated potassium channel-complex autoimmunity and associated clinical syndromes. Handb. Clin. Neurol. 2016;133:185–197. doi: 10.1016/B978-0-444-63432-0.00011-6. - DOI - PubMed
    1. Thompson J., Bi M., Murchison A.G., Makuch M., Bien C.G., Chu K., Farooque P., Gelfand J.M., Geschwind M.D., Hirsch L.J., Somerville E., Lang B., Vincent A., Leite M.I., Waters P., Irani S.R., Faciobrachial Dystonic Seizures Study Group Faciobrachial Dystonic Seizures Study Group. The importance of early immunotherapy in patients with faciobrachial dystonic seizures. Brain. 2018;141:348–356. doi: 10.1093/brain/awx323. - DOI - PMC - PubMed