Preexisting Serum Autoantibodies Against the NMDAR Subunit NR1 Modulate Evolution of Lesion Size in Acute Ischemic Stroke
2015
Background and Purpose—Recently, we reported high
seroprevalence(age-dependent up to >19%) of N-methyl-d-aspartate-receptor subunit NR1 (NMDAR1)
autoantibodiesin both healthy and neuropsychiatrically ill subjects (N=4236). Neuropsychiatric syndrome relevance was restricted to individuals with compromised
blood–brain barrier, for example, apolipoprotein E4 (APOE4) carrier status, both clinically and experimentally. We now hypothesized that these
autoantibodiesmay upon stroke be protective in individuals with hitherto intact
blood–brain barrier, but harmful for subjects with chronically compromised
blood–brain barrier.
Methods—Of 464 patients admitted with acute ischemic stroke in the middle cerebral artery territory, blood for NMDAR1
autoantibodymeasurements and APOE4 carrier status as indicator of a preexisting leaky
blood–brain barrierwas collected within 3 to 5 hours after stroke. Evolution of lesion size (delta day 7–1) in diffusion-weighted magnetic resonance imaging was primary outcome parameter...
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