Expression of Various Glutamate Receptors Including N-Methyl-D-Aspartate Receptor (NMDAR) in an Ovarian Teratoma Removed from a Young Woman with Anti-NMDAR Encephalitis
スポンサーリンク
概要
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A 21-year-old woman developed psychiatric symptoms, progressive unresponsiveness, generalized seizures, severe dyskinesia, marked fluctuation of blood pressure, and hypersalivation after a flu-like episode. Anti-glutamate receptor (GluR)ε2 and anti-N-methyl-D-aspartate receptor (NMDAR) antibodies were positive in both her serum and CSF. After she recovered five months later she underwent surgery to remove a right ovarian teratoma. Immunohistochemical examinations of her teratoma disclosed abundant expression of various GluRs including NR2B subunit of NMDAR, GluR1, and GluR2/3. These immunoreactivities of GluRs were seen not only in small areas of neural tissue identified as anti-glial fibrillary acidic protein (GFAP)-immunoreactive areas but also in other large areas of undifferentiated neuroepithelial tissue without GFAP immunoreactivity. Our findings strongly support the recent idea that neural elements in ovarian teratoma play an important role in the production of antibodies to NMDARs in anti-NMDAR encephalitis. Additionally, the study of control ovaries clearly showed NR2B-related immunoreactivity in the cytoplasm of oocytes, indicating that the normal ovary itself has expression of NMDARs. This finding might provide a clue to understand the pathogenesis of this disease in female patients without ovarian teratoma.
著者
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Takahashi Yukitoshi
National Epilepsy Center Shizuoka Institute Of Epilepsy And Neurological Disorders
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Yoshida Takuhiro
Department of Internal Medicine (Neurology and Rheumatology), Shinshu University School of Medicine
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Tachibana Naoko
Department Of Brain Pathophysiology Human Brain Research Center Kyoto University Graduate School Of
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Ishii Keiko
Department Of Clinical Laboratory Medicine Shinshu University School Of Medicine
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Arima Kunimasa
Department Of Laboratory Medicine Musashi Hospital National Center Of Neurology And Psychiatry
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Ikeda Shu-ichi
Department Of Internal Medicine (neurology And Rheumatology) Shinshu University School Of Medicine
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Tanaka Keiko
Department Of Anesthesiology Akashi Municipal Hospital
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Shirakawa Takashi
Department of Electronics and Information, Faculty of Engineering, Toin University of Yokohama, Yokohama 225-8503, Japan
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Shirakawa Takashi
Department of Gynecology, Okaya City Hospital
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Tachibana Naoko
Department of Medicine (Neurology), Okaya City Hospital
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