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 A-K., 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 S-T., 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