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Autoantibodies and the Immune Hypothesis in Psychotic Brain Diseases: Challenges and Perspectives

机译：自身抗体和精神病性脑疾病的免疫假设：挑战和观点。

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The pathophysiology of psychosis is poorly understood, with both the cognitive and cellular changes of the disease process remaining mysterious. There is a growing body of evidence that points to dysfunction of the immune system in a subgroup of patients with psychosis. Recently, autoantibodies directed against neuronal cell surface targets have been identified in a range of syndromes that feature psychosis. Of interest is the detection of autoantibodies in patients whose presentations are purely psychiatric, such as those suffering from schizophrenia. Autoantibodies have been identified in a minority of patients, suggesting that antibody-associated mechanisms of psychiatric disease likely only account for a subgroup of cases. Recent work has been based on the application of cell-based assays—a paradigm whose strength lies in the expression of putative antigens in their natural conformation on the surface of live cells. The responsiveness of some of these newly described clinical syndromes to immune therapy supports the hypothesis that antibody-associated mechanisms play a role in the pathogenesis of psychotic disease. However, further investigation is required to establish the scope and significance of antibody pathology in psychosis. The identification of a subgroup of patients with antibody-mediated disease would promise more effective approaches to the treatment of these high-morbidity conditions.
机译：精神病的病理生理学知之甚少，疾病过程的认知和细胞变化仍然是未知的。越来越多的证据表明，在精神病患者亚组中免疫系统功能异常。最近，在一系列以精神病为特征的综合征中，已经确定了针对神经细胞表面靶标的自身抗体。令人感兴趣的是，在表现纯属精神病的患者（例如精神分裂症患者）中检测自身抗体。在少数患者中已鉴定出自身抗体，这表明与精神科疾病相关的抗体机制可能仅占病例的亚组。最近的工作基于基于细胞的测定法的应用，这种测定法的优势在于在活细胞表面上以其天然构象表达假定的抗原。这些新近描述的临床综合征中的一些对免疫疗法的反应性支持了以下假设：抗体相关机制在精神病的发病机理中起作用。但是，需要进一步研究来确定精神病中抗体病理学的范围和意义。鉴定具有抗体介导的疾病的患者亚组将有望为治疗这些高发病率疾病提供更有效的方法。

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