Herpes simplex virus encephalitis is a trigger of brain autoimmunity

Thaís Armangue; Frank Leypoldt; Ignacio Málaga; Miquel Raspall-Chaure; Itxaso Marti; Charles Nichter; John Pugh; Monica Vicente-Rasoamalala; Miguel Lafuente-Hidalgo; Alfons MacAya; Michael Ke; Maarten J. Titulaer; Romana Höftberger; Heather Sheriff; Carol Glaser; Josep Dalmau

doi:10.1002/ana.24083

Herpes simplex virus encephalitis is a trigger of brain autoimmunity

Thaís Armangue, Frank Leypoldt, Ignacio Málaga, Miquel Raspall-Chaure, Itxaso Marti, Charles Nichter, John Pugh, Monica Vicente-Rasoamalala, Miguel Lafuente-Hidalgo, Alfons MacAya, Michael Ke, Maarten J. Titulaer, Romana Höftberger, Heather Sheriff, Carol Glaser, Josep Dalmau^*

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › Academic › peer-review

373 Citations (Scopus)

Abstract

In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p = 0.004; cerebrospinal fluid, p = 0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity.

Original language	English
Pages (from-to)	317-323
Number of pages	7
Journal	Annals of Neurology
Volume	75
Issue number	2
DOIs	https://doi.org/10.1002/ana.24083
Publication status	Published - Feb 2014

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Armangue, T., Leypoldt, F., Málaga, I., Raspall-Chaure, M., Marti, I., Nichter, C., Pugh, J., Vicente-Rasoamalala, M., Lafuente-Hidalgo, M., MacAya, A., Ke, M., Titulaer, M. J., Höftberger, R., Sheriff, H., Glaser, C., & Dalmau, J. (2014). Herpes simplex virus encephalitis is a trigger of brain autoimmunity. Annals of Neurology, 75(2), 317-323. https://doi.org/10.1002/ana.24083

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title = "Herpes simplex virus encephalitis is a trigger of brain autoimmunity",

abstract = "In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p = 0.004; cerebrospinal fluid, p = 0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity.",

author = "Tha{\'i}s Armangue and Frank Leypoldt and Ignacio M{\'a}laga and Miquel Raspall-Chaure and Itxaso Marti and Charles Nichter and John Pugh and Monica Vicente-Rasoamalala and Miguel Lafuente-Hidalgo and Alfons MacAya and Michael Ke and Titulaer, {Maarten J.} and Romana H{\"o}ftberger and Heather Sheriff and Carol Glaser and Josep Dalmau",

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Armangue, T, Leypoldt, F, Málaga, I, Raspall-Chaure, M, Marti, I, Nichter, C, Pugh, J, Vicente-Rasoamalala, M, Lafuente-Hidalgo, M, MacAya, A, Ke, M, Titulaer, MJ, Höftberger, R, Sheriff, H, Glaser, C & Dalmau, J 2014, 'Herpes simplex virus encephalitis is a trigger of brain autoimmunity', Annals of Neurology, vol. 75, no. 2, pp. 317-323. https://doi.org/10.1002/ana.24083

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AU - Armangue, Thaís

AU - Leypoldt, Frank

AU - Málaga, Ignacio

AU - Raspall-Chaure, Miquel

AU - Marti, Itxaso

AU - Nichter, Charles

AU - Pugh, John

AU - Vicente-Rasoamalala, Monica

AU - Lafuente-Hidalgo, Miguel

AU - MacAya, Alfons

AU - Ke, Michael

AU - Titulaer, Maarten J.

AU - Höftberger, Romana

AU - Sheriff, Heather

AU - Glaser, Carol

AU - Dalmau, Josep

PY - 2014/2

Y1 - 2014/2

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AB - In 5 prospectively diagnosed patients with relapsing post-herpes simplex encephalitis (HSE), N-methyl-D-aspartate receptor (NMDAR) antibodies were identified. Antibody synthesis started 1 to 4 weeks after HSE, preceding the neurological relapse. Three of 5 patients improved postimmunotherapy, 1 spontaneously, and 1 has started to improve. Two additional patients with NMDAR antibodies, 9 with unknown neuronal surface antibodies, and 1 with NMDAR and unknown antibodies, were identified during retrospective assessment of 34 HSE patients; the frequency of autoantibodies increased over time (serum, p = 0.004; cerebrospinal fluid, p = 0.04). The 3 retrospectively identified NMDAR antibody-positive patients also had evidence of relapsing post-HSE. Overall, these findings indicate that HSE triggers NMDAR antibodies and potentially other brain autoimmunity.

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Herpes simplex virus encephalitis is a trigger of brain autoimmunity

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