It must be said that we have been looking for autoantibodies in patients, particularly epileptics, for ages to explain the persistence of seizures. The idea in a simplified way is that the body would produce antibodies against important proteins, neutralizing their actions a bit as if they had been injected with an antagonist or an inhibitor of this target, except that it is endogenous. Imagine your body producing an agent that makes you seriously ill. For a long time, a few scientific articles suggested this possibility but were quickly refuted.
Then around 2007, German researcher/clinician Josep Dalnau discovered antibodies targeting NMDA receptors in the bodies of patients suffering from severe depression. As a reminder, the NMDA receptor is a receptor playing a major role in particular in memory processes and in general neuronal integration. Antagonists of this receptor were considered at one time in particular as antiepileptics before proving to have seriously disabling actions with a proximity to the effects of certain hallucinogens/synthetic drugs. a blocker of these receptors can logically have many harmful effects on the brain and as it is manufactured permanently, we understand its harmful effects.
Since then, around fifteen serious neurological and psychiatric illnesses have been described in different patients. It is interesting to note that a viral infection can cause the expression of this production of autoantibodies. It should also be noted that the treatment is essentially based on anti-inflammatories (often cortisone) which reminds us how inflammation is at the heart of these diseases as it is at the heart of syndromes like autism (see my blog) . Alin Sternberg was a brilliant medical student, and suddenly she began to gain weight, have serious muscle problems and eventually lost all connection with life, including an inability to find her home. A test for autoantibodies does reveal autoantibodies against an association protein (the Like 2 protein) which is essential for synaptic transmission. An intravenous cortisone treatment brought him back completely as if nothing had happened. a Obviously, however, these treatments cannot be taken continuously given the vulnerability to infections and a race against time is underway to find monoclonal antibodies to replace corticosteroid therapy.
Since then, this approach has been used in the plural in Alzheimer’s disease and many others. This reminds me of these astonishing observations of permanent lethargy in people who seem neurologically dead, in any case incapable of any manifestation or interaction. However, the administration of valium – which normally produces sleeping pill and anesthetic effects – on the contrary suddenly wakes them up. The lesson of this story is that we must not fear being in tune with the dominant fashions. It must also be emphasized how these psychiatric illnesses are heterogeneous in their genesis but ultimately have in common that they have an inflammatory component as if this were a common final pathway.
Photo : Science.org / Thomas Müller displays his artwork, some of which was inspired by his experience with psychosis brought on by autoimmune encephalitis. Lena Giovanazzi
