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Review Article

Anti‑N‑methyl‑D‑aspartate receptor encephalitis

in China

2
1
Li Li , Cheng‑Bin Wang , Gang Zhao 1
1 Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China.
2 Department of Clinical Medicine, Fourth Military Medical University, Xi’an 710032, Shaanxi, China.

ABSTRA CT
N-methyl-D-aspartate receptors (NMDARs) are mainly distributed in the central nervous system, and play important roles in the
mechanisms of learning and memory. A newly discovered disease caused by autoantibody to NMDAR has been described, and is
called anti-NMDAR encephalitis. Patients with this disease often suffer from mental disorders, seizures and other encephalitis-like
symptoms. Accumulated data suggests that the severity of the disease makes early diagnosis very important. Accurately detecting
the autoantibody to NMDAR is considered to be the gist of diagnosis. Good prognosis is predicted in most patients, when treated
properly. Immunotherapy is preferred in most cases. In China, this disease has been reported only for a few years, but sporadic case
reports are also helpful for profiling.
Key words: Encephalitis, N-methyl-D-aspartate, therapy

INTRODUCTION message to produce a slow physiological reaction.
Another class is ionotropic glutamate-receptors (iGluRs)
N‑methyl‑D‑aspartate that constitute ligand-gated ion channel complex
N-methyl-D-aspartate ( NMDA) is an artificially synthesized and mediate transduction of rapid physiological
amino acid with a similar structure to glutamate, and can signals. Based on agonist preference, iGluRs can be
activate a certain type of glutamate-receptor located in categorized into three different groups. Receptors that
postsynaptic membrane. High-dose NMDA could cause can be activated by the synthetic agonist NMDA are
neuronal death by inducing excitotoxicity, and was called NMDA receptors (NMDARs) or NMDA-GluRs to
used in behavioral neuroscience studies. Subsequently, understand their nature better. The other two groups
low-dose NMDA was used to investigate the roles of
glutamate and glutamate-receptor pathway in the central are α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic
[2]
nervous system (CNS). [1] acid (AMPA) receptors and kainate receptors.
Glutamate‑receptor and N‑methyl‑D‑aspartate receptor Structure and physiological features of NMDA receptor
Glutamate-receptors in the CNS can be classified into two NMDA receptor is a tetramer, which is composed of
classes. One class is metabotropic glutamate-receptors three subunits: NR1, NR2, and NR3. In mammalian
coupled with a type of G-protein, whose activation neural tissues, the functional NMDARs contain at least
mediates signal transduction cascade based on second NR1 and NR2 subunits, in which NR1 functions as the
ion channel, NR2 possesses regulatory function for the
[3]
Access this article online receptor, and NR3 could act as the regulatory subunit.
2+
Quick Response Code: NMDARs are highly permeable for Ca , which acts as
Website: the second message to regulate some cellular signal
www.nnjournal.net
transduction pathways. NMDARs are also important for
DOI: neurons to maintain normal function and morphology.
10.4103/2347-8659.135571 The normal physiological level of Mg blocks NMDAR,
2+
so its biological activity relies on a certain degree of

Corresponding Author: Dr. Li Li, Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032,
Shaanxi, China. E‑mail: lili@fmmu.edu.cn

Neuroimmunol Neuroinflammation | Volume 1 | Issue 1 | June 2014 17