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A systematic review of Gamma-aminobutyric Acid Receptor Type B autoimmunity
Affiliations- Mayo Clinic, Jacksonville, Florida, United States
- Mayo Clinic Minnesota, Rochester, Minnesota, United States
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Abstract
Objective. To review the available research to describe the clinical characteristics and neoplastic associations of patients with gamma-aminobutyric acid receptor type B (GABAB-R) autoantibodies.
Methods. Literature was reviewed on PubMed, Mendeley literature search, and the American Academy of Neurology database for articles published from June 2008 to October of 2018 using a variety of key words. These key words include: „gamma-aminobutyric acid seizures,” „gamma-aminobutyric acid limbic encephalitis”, „GABA(B) receptor antibodies,” „autoimmune encephalitis,” „autoimmune epilepsy,” „GABA(B) encephalitis, „ and “GABA paraneoplastic.” With the results, the papers were reviewed in a systematic manner.
Results. A total of 10 studies were reviewed. A summary of the demographic, clinical, and serological findings of the cases detailed in the literature are provided. An additional illustrative case is described. In total, 94 patients were reviewed.
Conclusions. GABAB-R autoimmune disease is characterized by refractory seizures or status epilepticus and frequent association with small cell lung cancer. Additionally, a substantial minority of patients have non-inflammatory CSF.
Abstract
Objective. To review the available research to describe the clinical characteristics and neoplastic associations of patients with gamma-aminobutyric acid receptor type B (GABAB-R) autoantibodies.
Methods. Literature was reviewed on PubMed, Mendeley literature search, and the American Academy of Neurology database for articles published from June 2008 to October of 2018 using a variety of key words. These key words include: „gamma-aminobutyric acid seizures,” „gamma-aminobutyric acid limbic encephalitis”, „GABA(B) receptor antibodies,” „autoimmune encephalitis,” „autoimmune epilepsy,” „GABA(B) encephalitis, „ and “GABA paraneoplastic.” With the results, the papers were reviewed in a systematic manner.
Results. A total of 10 studies were reviewed. A summary of the demographic, clinical, and serological findings of the cases detailed in the literature are provided. An additional illustrative case is described. In total, 94 patients were reviewed.
Conclusions. GABAB-R autoimmune disease is characterized by refractory seizures or status epilepticus and frequent association with small cell lung cancer. Additionally, a substantial minority of patients have non-inflammatory CSF.
Keywords
Gamma-aminobutyric acid seizures, gamma-aminobutyric acid receptor type B, GABA(B) receptor antibodies, autoimmune encephalitis, autoimmune epilepsy, GABA-B encephalitis, GABA limbic encephalitis, GABA paraneoplastic
About this articleTitle
A systematic review of Gamma-aminobutyric Acid Receptor Type B autoimmunity
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Invited Review Article
Pages
1-7
Published online
2019-01-07
Page views
3060
Article views/downloads
2357
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(1):1-7.
Keywords
Gamma-aminobutyric acid seizures
gamma-aminobutyric acid receptor type B
GABA(B) receptor antibodies
autoimmune encephalitis
autoimmune epilepsy
GABA-B encephalitis
GABA limbic encephalitis
GABA paraneoplastic
Authors
Jake H. McKay
Elliot L. Dimberg
Alfonso S. Lopez Chiriboga
References (27)- Dalmau J, Tüzün E, Wu Hy, et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 2007; 61(1): 25–36.
- Gable MS, Sheriff H, Dalmau J, et al. The frequency of autoimmune N-methyl-D-aspartate receptor encephalitis surpasses that of individual viral etiologies in young individuals enrolled in the California Encephalitis Project. Clin Infect Dis. 2012; 54(7): 899–904.
- Lancaster E, Lai M, Peng X, et al. Antibodies to the GABAB receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. The Lancet Neurology. 2010; 9(1): 67–76.
- Boronat A, Sabater L, Saiz A, et al. GABA(B) receptor antibodies in limbic encephalitis and anti-GAD-associated neurologic disorders. Neurology. 2011; 76(9): 795–800.
- Höftberger R, Titulaer MJ, Sabater L, et al. Encephalitis and GABAB receptor antibodies: novel findings in a new case series of 20 patients. Neurology. 2013; 81(17): 1500–1506.
- Guan HZ, Ren HT, Yang XZ, et al. Limbic Encephalitis Associated with Anti-γ-aminobutyric Acid B Receptor Antibodies: A Case Series from China. Chin Med J (Engl). 2015; 128(22): 3023–3028.
- Onugoren MD, Deuretzbacher D, Haensch CA, et al. Limbic encephalitis due to GABABand AMPA receptor antibodies: a case series. Journal of Neurology, Neurosurgery & Psychiatry. 2014; 86(9): 965–972.
- Benarroch EE. GABAB receptors: structure, functions, and clinical implications. Neurology. 2012; 78(8): 578–584.
- Fritschy JM, Meskenaite V, Weinmann O, et al. GABAB-receptor splice variants GB1a and GB1b in rat brain: developmental regulation, cellular distribution and extrasynaptic localization. Eur J Neurosci. 1999; 11(3): 761–768.
- Schuler V, Lüscher C, Blanchet C, et al. Epilepsy, hyperalgesia, impaired memory, and loss of pre- and postsynaptic GABA(B) responses in mice lacking GABA(B(1)). Neuron. 2001; 31(1): 47–58.
- Dalmau J, Geis C, Graus F. Autoantibodies to Synaptic Receptors and Neuronal Cell Surface Proteins in Autoimmune Diseases of the Central Nervous System. Physiological Reviews. 2017; 97(2): 839–887.
- Kim TJ, Lee ST, Shin JW, et al. Clinical manifestations and outcomes of the treatment of patients with GABAB encephalitis. J Neuroimmunol. 2014; 270(1-2): 45–50.
- Chen X, Liu F, Li JM, et al. Encephalitis with antibodies against the GABAB receptor: seizures as the most common presentation at admission. Neurological Research. 2017; 39(11): 973–980.
- Alexopoulos H, Dagklis IE, Akrivou S, et al. Autoimmune encephalitis with GABAB antibodies, thymoma, and GABAB receptor thymic expression. Neurol Neuroimmunol Neuroinflamm. 2014; 1(4): e39.
- Jarius S, Steinmeyer F, Knobel A, et al. GABAB receptor antibodies in paraneoplastic cerebellar ataxia. J Neuroimmunol. 2013; 256(1-2): 94–96.
- DeFelipe-Mimbrera A, Masjuan J, Corral Í, et al. Opsoclonus-myoclonus syndrome and limbic encephalitis associated with GABAB receptor antibodies in CSF. J Neuroimmunol. 2014; 272(1-2): 91–93.
- Wells EM, Dalmau J. Paraneoplastic neurologic disorders in children. Curr Neurol Neurosci Rep. 2011; 11(2): 187–194.
- Kruer MC, Hoeftberger R, Lim KY, et al. Aggressive course in encephalitis with opsoclonus, ataxia, chorea, and seizures: the first pediatric case of γ-aminobutyric acid type B receptor autoimmunity. JAMA Neurol. 2014; 71(5): 620–623.
- Chen X, Liu F, Li JM, et al. Encephalitis with antibodies against the GABA receptor: seizures as the most common presentation at admission. Neurol Res. 2017; 39(11): 973–980.
- Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013; 12(2): 157–165.
- Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008; 7(12): 1091–1098.
- Graus F. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain. 2001; 124(6): 1138–1148.
- Escudero D, Guasp M, Ariño H, et al. Antibody-associated CNS syndromes without signs of inflammation in the elderly. Neurology. 2017; 89(14): 1471–1475.
- Kalemkerian GP. Small Cell Lung Cancer. Semin Respir Crit Care Med. 2016; 37(5): 783–796.
- Titulaer MJ, Soffietti R, Dalmau J, et al. European Federation of Neurological Societies. Screening for tumours in paraneoplastic syndromes: report of an EFNS task force. Eur J Neurol. 2011; 18(1): 19–e3.
- McKeon A, Apiwattanakul M, Lachance DH, et al. Positron emission tomography-computed tomography in paraneoplastic neurologic disorders: systematic analysis and review. Arch Neurol. 2010; 67(3): 322–329.
- Mundiyanapurath S, Jarius S, Probst C, et al. GABA-B-receptor antibodies in paraneoplastic brainstem encephalitis. J Neuroimmunol. 2013; 259(1-2): 88–91.
