DOI: https://doi.org/10.29296/24999490-2021-01-01

O.V. Pavlova(1), K.A. Pavlov(1), A.A. Murashko(2), O.I. Gurina(1), A.B. Shmukler(2), 1-V. Serbsky National Medical Research Centre for Psychiatry and Narcology (V. Serbsky NMRCPN), Kropotkinsky bystreet, 23, Moscow, 119034, Russian Federation; 2-Moscow Research Institute of Psychiatry – the Branch of V. Serbsky National Medical Research Centre for Psychiatry and Narcology, Poteshnaya, 3, Moscow, 119034, Russian Federation E-mail: [email protected]

Little is known about the etiology of neuropsychiatric disorders. Glutamate-mediated excitotoxicity is one of the main pathological mechanisms occurring in various types of acute and chronic diseases of the central nervous system. Glutamate is the major excitatory neurotransmitter in the central nervous system. Recently, it has become evident that not only glutamate excess can cause massive brain damage. Several types of anti-glutamate receptor antibodies were found in serum and cerebrospinal fluid of patients with various mental and neuroinflammatory disorders. These antibodies can lead to the death of neurons and impaired neuronal function inducing various pathological mechanisms in the central nervous system. The discovery of autoantibodies binding to NMDA receptors and causing neurological and psychiatric symptoms has led to the hypothesis that autoimmune mechanisms may underlie some cases of mental disorders. This paper reviews the pathological mechanisms of antibodies against NMDA receptors based on the disorder defined as anti-NMDA receptor encephalitis. Anti-NMDA receptor encephalitis is a synaptic autoimmune disorder in which IgG autoantibodies against the NR1 subunit of the NMDA receptors occur and trigger pathological processes, manifesting with psychiatric symptoms in particular. The research in other mental and neuroinflammatory disorders also showed the presence of anti-NMDAR antibodies in a small part of patients. But the role of antibodies against the NMDA receptors in the development of psychotic symptoms is not fully understood and requires further research. Studies in this area are extremely promising, opening up new opportunities for understanding the pathogenesis of this group of disorders and developing new diagnostic and therapeutic approaches.
NMDA-receptors, autoantibodies, encephalitis, psychosis, neuroinflammatory diseases, NMDA

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