Cervical lymph nodes and ovarian teratomas as germinal centres in NMDA receptor-antibody encephalitis.
Al-Diwani A., Theorell J., Damato V., Bull J., McGlashan N., Green E., Kienzler AK., Harrison R., Hassanali T., Campo L., Browne M., Easton A., Soleymani Majd H., Tenaka K., Iorio R., Dale RC., Harrison P., Geddes J., Quested D., Sharp D., Lee ST., Nauen DW., Makuch M., Lennox B., Fowler D., Sheerin F., Waters P., Leite MI., Handel AE., Irani SR.
Autoantibodies against the extracellular domain of the N-methyl-d-aspartate receptor (NMDAR) NR1 subunit cause a severe and common form of encephalitis. To better understand their generation, we aimed to characterize and identify human germinal centres actively participating in NMDAR-specific autoimmunization by sampling patient blood, CSF, ovarian teratoma tissue and, directly from the putative site of human CNS lymphatic drainage, cervical lymph nodes. From serum, both NR1-IgA and NR1-IgM were detected more frequently in NMDAR-antibody encephalitis patients versus controls (both P