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Immune-mediated epilepsy with GAD65 antibodies
Journal of Neuroimmunology ( IF 3.3 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.jneuroim.2020.577189
Xinxin Li 1 , Qi Guo 1 , Zhaoshi Zheng 1 , Xiaoshuang Wang 1 , Songyan Liu 1
Affiliation  

Anti-GAD65 antibodies have been identified in both acute/subacute seizures (limbic encephalitis and extralimbic encephalitis) and chronic isolated epilepsy. The evidence of high serum titers and intrathecal synthesis play a fundamental role in diagnosis but poorly correlate with disease severity or response to therapies. It remains controversial whether anti-GAD65 Abs are the pathogenic entity or only serve as a surrogate marker for autoimmune disorders mediated by cytotoxic T cells. Unlike other immune-mediated epilepsy, although multiple combinations of therapeutics are used, the efficacy and prognosis of patients with GAD65-epilepsy patients are poor. Besides, GAD65-epilepsy is more prone to relapse and potentially evolve into a more widespread CNS inflammatory disorder. This article reviews the recent advances of GAD65-epilepsy, focusing on the diagnosis, epidemiology, pathophysiology, clinical features, and treatment, to better promote the recognition and provide proper therapy for this condition.

中文翻译:

免疫介导的癫痫与 GAD65 抗体

在急性/亚急性癫痫发作(边缘脑炎和边缘外脑炎)和慢性孤立性癫痫中均已鉴定出抗 GAD65 抗体。高血清滴度和鞘内合成的证据在诊断中起重要作用,但与疾病严重程度或对治疗的反应相关性较差。抗 GAD65 Ab 是致病实体还是仅作为由细胞毒性 T 细胞介导的自身免疫性疾病的替代标志物仍存在争议。与其他免疫介导的癫痫不同,虽然采用多种治疗方法组合,但GAD65-癫痫患者的疗效和预后较差。此外,GAD65-癫痫更容易复发,并有可能演变成更广泛的中枢神经系统炎症性疾病。本文回顾了GAD65-癫痫的最新进展,
更新日期:2020-04-01
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