The Diagnostic Value Of ?3gAChR Antibody In Autoimmune Neurologic Disorders And The Genetic Correlation Of Anti NMDA Receptor Encephalitis

BackgroundThere are many etiologies of autonomic failure,including degenerative,toxic,metabolic,and autoimmune causes.In many instances,acute or subacute autonomic failure can be attributed to an autoimmune etiology.Slowly progressive chronic autoimmune autonomic failure is also described,and this can be difficult to differentiate from chronic degenerative causes of autonomic failure.Autoimmune autonomic failure can also be seen in association with systemic rheumatological disorders(e.g.,Sjogren's syndrome,Guillain-Barre syndrome)or in association with cancer as a paraneoplastic syndrome.?3subunit of ganglionic neuronal nicotinic acetylcholine receptors are present in all autonomic ganglia including sympathetic,parasympathetic,and enteric systems.Approximately 50–60% of patients with AAG have anti-bodies to gnAChR and these specifically bind to ?3 subunit.And we can find seropositivityin the patients with Sjogren's syndrome,Guillain-Barre syndrome,andparaneoplastic syndrome which autoimmune diseasesmerge autonomic nerve damage.Autoimmune neurologic disorders,especially in the central nervous system,the correlation of disease symptoms,signs and laboratory examinations are gradually perfect.The mental behavior of the patients with autoimmune diseases is outstanding,so theinquisition,physical examination,electromyography often cannot fit in the process.Autonomic nerve damage which is one of the common symptoms is difficult for clinical diagnosis.In the epidemiological survey,different races of anti-NMDA receptor encephalitis incidenceare different,and Asians have high prevalence.It has been proved that the human leukocyte antigen(HLA)plays an important role in the pathogenesis of autoimmune diseases.But there is still not system research proving that anti-NMDA receptor encephalitis are related with HLA genes.ObjectiveThis study,using ELISA kit,detectedthe anti-?3 subunit of ganglionic neuronal nicotinic acetylcholine receptor in the serum of patients with anti-NMDA receptor encephalitis,PNS,Guillain-Barre syndrome,Parkinson's disease and healthy person.The positive ratesare contrasted among nervous system autoimmune diseases.The HLA genes of anti-NMDA receptor encephalitis patients were detectedby the polymerase chain reaction-directly sequenced,and comparative analyzed with the database of common Chinese population distribution of HLA genes locus.We assess therelationship ofanti-NMDA receptor encephalitis and HLA genes.MethodsThe detection of ?3-gAChR-Ab: We used enzyme labelled antibody,by the method of ELISA,totest ?3-gAChR-Ab in the serum.Evaluate its statistical significance through the statistical analysis.HLA genetic testing: We used the polymerase chain reaction-directly sequenced,to detectHLA-A,B,C,DQB1,DRB1 gene type of anti-NMDA receptor encephalitis patients,contrasting the frequency of HLA gene locus with the database of Chinese population distribution,and compare the differences between patients and normal frequency.Results: The positive rates of ?3gAChR antibody in the patients who suffer from NMDA receptor encephalitis or GBS are higher than healthy people.The ?3gAChR antibody levelsaboving 88.7ng/mL have a higher prompt to autonomic failure in the patients with autoimmune neurologic disorders.The HLA-A,-B,-C,-DQB1,-DRB1 gene loci of the 11 patients with anti-NMDA receptor encephalitis patients is on the sites of Chinese common.Conclusion:The positive rates of ?3gAChR antibody in the patients who suffer from NMDA receptor encephalitis or GBS are higher than healthy people.The ?3gAChR antibody levels aboving 88.7ng/mL have a higher prompt to autonomic failure in the patients with autoimmune neurologic disorders.The HLA gene loci of the patients with anti-NMDA receptor encephalitis have no obvious difference from the Chinese common sites.