Serum Nuclear Magnetic Resonance Lipidomics Study Of Patients With Anti-NMDAR Encephalitis

BackgroundIn 2007,Dalmau J found a kind of neuropsychiatric syndrome characterized by epilepsy,cognitive impairment and mental disorders,which is antibody-mediated antiN-methyl-D-aspartate receptor encephalitis,referred to as anti-NMDAR encephalitis.With the promotion of autoimmune encephalitis antibody detection technology around the world,the diagnosis rate of anti-NMDAR encephalitis has greatly increased.It is found that anti-NMDAR encephalitis is the most common central nervous system(CNS)autoimmune encephalitis,with a prevalence rate of 0.6 / 100000,accounting for 6% /10% of the total encephalitis.In the past ten years,anti-NMDAR encephalitis has become a hot topic in neuroimmunology.NMDAR is a heterotetramer ionic glutamate receptor composed of seven subunits(Glu N1,Glu N2A～D,Glu N3 A,B).The pathophysiological changes caused by antiNMDAR antibody combined with Glu N1 subunit is an important link in anti-NMDAR encephalitis.Detection of NMDAR antibodies in serum and cerebrospinal fluid is an important basis for the diagnosis of anti-NMDAR encephalitis.Lipid metabolism is involved in a variety of inflammatory and autoimmune diseases.CNS autoimmune disease multiple sclerosis(MS)has lipid metabolism disorder and participates in the pathophysiological process of MS.We speculate that lipid metabolism may also be involved in the pathophysiological process of CNS autoimmune disease against NMDAR encephalitis.ObjectiveIn this study,more detailed lipid components and their subcomponents in the serum of patients with anti-NMDAR encephalitis were detected by nuclear magnetic resonance lipidomics,and the changes of lipid metabolism in anti-NMDAR encephalitis were preliminarily explored.MethodsThe clinical data and serum samples of patients with anti-NMDAR encephalitis were collected,and the lipoproteins and subgroups in serum of patients with antiNMDAR encephalitis were detected by nuclear magnetic resonance liposome.To analyze the difference of lipid composition in serum of anti-NMDAR encephalitis and non-inflammatory disease control group.ResultsThere were significant differences in serum lipid composition in patients with anti-NMDAR encephalitis,including:1.Elevated cholesterol.Total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),intermediate density lipoprotein cholesterol(IDL-C),low density lipoprotein cholesterol(LDL-C),low density lipoprotein-6 cholesterol(LDL-6-C),high density lipoprotein-2 free cholesterol(HDL-2 Free cholesterol),high density lipoprotein-3 free cholesterol(HDL-3 Free cholesterol),Intermediate density lipoprotein free cholesterol(IDL Free cholesterol),low density lipoprotein free cholesterol(LDL Free cholesterol),low density lipoprotein-1 free cholesterol(LDL-1 Free cholesterol),low density lipoprotein-5 free cholesterol(LDL-5 Free cholesterol),low density lipoprotein-6 free cholesterol(LDL-6 Free cholesterol),very low density lipoprotein-5 free cholesterol(VLDL-5 Free cholesterol)increased.2.The number of lipid particles increased.The number of total particles,low density lipoprotein particles,low density lipoprotein-1 particles and lowdensity lipoprotein-6 particles increased.3.Lipoprotein phospholipids are elevated.Low density lipoprotein phospholipid(LDL Phospholipids)and lowdensity lipoprotein-6 phospholipid(LDL-6Phospholipids)increased.4.Elevated triglycerides.Low density lipoprotein-3 triglyceride(LDL-3 Triglycerides)and lowdensity lipoprotein-6 triglyceride(LDL-6 Triglycerides)increased.5.Apolipoproteins are elevated.Apolipoprotein A2(Apo-A2),apolipoprotein B(Apo-B),high density lipoprotein apolipoprotein A2(HDL Apo-A2),high density lipoprotein-3 apolipoprotein A2(HDL-3 Apo A2),high density lipoprotein-4apolipoprotein A2(HDL-4 Apo-A2),low density lipoprotein apolipoprotein B(LDL Apo-B),low density lipoprotein-1 apolipoprotein B(LDL-1 Apo-B),low density lipoprotein-6 apolipoprotein B(LDL-6 Apo-B)increased.Conclusion1、 The serum of patients with anti-NMDAR encephalitis was detected by nuclear magnetic resonance lipidomics.It was found that not only the serum lipid components that could be detected by biochemical detection were increased,but also the more subdivided lipid components were increased.2、 This study found that the lipid composition of patients with anti-NMDAR encephalitis increased in an all-round way,suggesting that abnormal lipid metabolism may be one of the factors promoting the occurrence of anti-NMDAR encephalitis.