Journal
PHYSIOLOGICAL REVIEWS
Volume 97, Issue 2, Pages 839-887Publisher
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/physrev.00010.2016
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Funding
- National Institutes of Health [RO1NS077851]
- Instituto Carlos III Fondo de Investigaciones Sanitarias/FEDER [FIS 14/00203, FIS 15/00377]
- CIBERER
- Fundacio CELLEX
- German Research Council, DFG [GE 2519/3-1, CRC-TR 166/1 B2]
- Fundacio la Marato [TV3 2014-1830]
- ICREA Funding Source: Custom
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Investigations in the last 10 years have revealed a new category of neurological diseases mediated by antibodies against cell surface and synaptic proteins. There are currently 16 such diseases all characterized by autoantibodies against neuronal proteins involved in synaptic signaling and plasticity. In clinical practice these findings have changed the diagnostic and treatment approach to potentially lethal, but now treatable, neurological and psychiatric syndromes previously considered idiopathic or not even suspected to be immune-mediated. Studies show that patients' antibodies can impair the surface dynamics of the target receptors eliminating them from synapses (e.g., NMDA receptor), block the function of the antigens without changing their synaptic density (e.g., GABAb receptor), interfere with synaptic protein-protein interactions (LGI1, Caspr2), alter synapse formation (e.g., neurexin-3 alpha), or by unclear mechanisms associate to a new form of tauopathy (IgLON5). Here we first trace the process of discovery of these diseases, describing the triggers and symptoms related to each autoantigen, and then review in detail the structural and functional alterations caused by the autoantibodies with special emphasis in those (NMDA receptor, amphiphysin) that have been modeled in animals.
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