Autoimmunity in psychotic disorders. Where we stand, challenges and opportunities

Autoimmun Rev. 2019 Sep;18(9):102348. doi: 10.1016/j.autrev.2019.102348. Epub 2019 Jul 16.

Abstract

Psychotic disorders are debilitating mental illnesses associated with abnormalities in various neurotransmitter systems. The development of disease-modifing therapies has been hampered by the mostly unknown etiologies and pathophysiologies. Autoantibodies against several neuronal antigens are responsible for autoimmune encephalitis. These autoantibodies disrupt neurotransmission within the brain, resulting in a wide range of psychiatric and neurologic manifestations, including psychosis. The overlap of symptoms of autoimmune encephalitis with psychotic disorders raised the question as to whether autoantibodies against a number of receptors, ion channel and associated proteins could ultimately be responsible for some forms of psychosis. Here we review our current knowledge, on antibody mediated autoimmunity in psychotic disorders, the different diagnostic methods and their limitations, as well as on varying therapeutic approaches targeting the immune system.

Keywords: Autoantibodies; Channelopathies; Immunotherapy; Neuropsychiatric; Psychosis.

Publication types

  • Review

MeSH terms

  • Autoantibodies / analysis
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Autoimmunity / physiology*
  • Brain / physiology
  • Encephalitis / diagnosis
  • Encephalitis / immunology
  • Encephalitis / therapy
  • Hashimoto Disease / diagnosis
  • Hashimoto Disease / immunology
  • Hashimoto Disease / therapy
  • Humans
  • Immune System / physiology
  • Immunologic Tests / methods
  • Immunologic Tests / trends*
  • Immunotherapy / methods
  • Immunotherapy / trends*
  • Molecular Targeted Therapy / methods
  • Molecular Targeted Therapy / trends
  • Neurons / immunology
  • Neurons / pathology
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / immunology*
  • Psychotic Disorders / therapy*

Substances

  • Autoantibodies

Supplementary concepts

  • Hashimoto's encephalitis