Circulating autoantibodies against glutamatergic N-methyl-D-aspartate receptor (NMDAR) have been reported in a proportion of patients with psychotic disorders, raising hopes for more appropriate treatment for these antibody-positive patients. However, the prevalence of circulating autoantibodies against glutamatergic NMDAR in psychotic disorders remains controversial, with detection prevalence rates and immunoglobulin classes varying considerably between studies, perhaps because of different detection methods. Here, we compared the results of serum assays for a large cohort of patients with first-episode psychosis using classical cell-based assays in three labs and a single molecule-based imaging method. Most assays and single molecule imaging in live hippocampal neurons revealed the presence of circulating autoantibodies against glutamatergic NMDAR in approximately 5% of patients with first-episode psychosis. However, some heterogeneity between cell-based assays was clearly observed, highlighting the urgent need for new sensitive methods to detect the presence of low-titer autoantibodies against glutamatergic NMDAR in seropositive patients who cannot be clinically identified from seronegative ones.

中文翻译：

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基于细胞和单分子的方法检测来自优化项目的首发精神病患者的抗 N-甲基-D-天冬氨酸受体自身抗体

部分精神病患者报告了针对谷氨酸能 N-甲基-D-天冬氨酸受体 (NMDAR) 的循环自身抗体，这为这些抗体阳性患者提供更合适的治疗带来了希望。然而，针对精神障碍中谷氨酸能 NMDAR 的循环自身抗体的流行仍然存在争议，可能是因为检测方法不同，检测流行率和免疫球蛋白类别在不同研究之间存在很大差异。在这里，我们在三个实验室中使用基于细胞的经典检测方法和基于单分子的成像方法比较了大量首发精神病患者的血清检测结果。活海马神经元中的大多数测定和单分子成像显示，大约 5% 的首发精神病患者存在针对谷氨酸能 NMDAR 的循环自身抗体。然而，清楚地观察到基于细胞的测定之间的一些异质性，强调迫切需要新的敏感方法来检测血清阳性患者中抗谷氨酸能 NMDAR 的低滴度自身抗体的存在，这些患者在临床上无法从血清阴性患者中识别出来。