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Einfluss von Anti-NMDA-Rezeptor-NR1-Autoantikörpern bei ApoE4-bedingter chronischer Beeinträchtigung der Blut-Hirn-Schranke

dc.contributor.advisorEhrenreich, Hannelore Prof. Dr. Dr.
dc.contributor.authorZerche, Maria
dc.date.accessioned2018-07-18T06:44:19Z
dc.date.available2018-07-26T22:50:03Z
dc.date.issued2018-07-18
dc.identifier.urihttp://hdl.handle.net/11858/00-1735-0000-002E-E454-5
dc.identifier.urihttp://dx.doi.org/10.53846/goediss-6967
dc.language.isodeude
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc610de
dc.titleEinfluss von Anti-NMDA-Rezeptor-NR1-Autoantikörpern bei ApoE4-bedingter chronischer Beeinträchtigung der Blut-Hirn-Schrankede
dc.typedoctoralThesisde
dc.title.translatedRole of anti-NMDA-receptor NR1 autoantibodies depending on ApoE4 related chronic impairment of the blood brain barrierde
dc.contributor.refereeEhrenreich, Hannelore Prof. Dr. Dr.
dc.date.examination2018-07-19
dc.description.abstractengAnti-N-methyl-D-aspartate-receptor subunit 1 autoantibodies (NMDAR-NR1-AB) have mainly been described in context of central nervous system (CNS) pathologies. In contrast, recent studies reported high seroprevalence of NMDAR-NR1-AB in both healthy and neuropsychiatrically ill subjects. It was hypothesized that this might be due to the significance of the blood-brain barrier (BBB) for both development and potential effects of CNS-reactive AB. Apolipoprotein E4 (ApoE4) represents a genetic risk factor for a chronically impaired BBB. Therefore, the present study investigates the role of NMDAR-NR1-AB depending on ApoE4-related chronic impairment of the BBB. ApoE genotype and NMDAR-NR1-AB seropositivity were determined in a cohort of 2492 neuropsychiatric patients and healthy control subjects as well as a second cohort of 464 patients with acute ischemic stroke of the middle cerebral artery. A high seroprevalence of NMDAR-NR1-AB independent of disease status could be replicated and extended to older age groups. The interaction of APOE4 carrier status and NMDAR-NR1-AB seropositivity was found to be significantly associated with the diagnosis of schizoaffective disorder. In patients with acute ischemic stroke, pre-existing NMDAR-NR1-AB were found to modulate the evolution of lesion size in diffusion-weighted magnetic resonance imaging (DW-MRI). The present results demonstrate the importance of BBB integrity for the influence of NMDA-NR1-AB. Both projects provide evidence of ApoE4-related chronic BBB disruption mediating pathological NMDAR-NR1-AB effects not occurring in patients with an intact BBB. Furthermore, first data for beneficial effects of circulating CNS-reactive AB is provided supporting the concept of physiological autoimmunity.de
dc.contributor.coRefereeLiman, Jan Dr.
dc.contributor.thirdRefereeMeyer, Thomas Prof. Dr.
dc.subject.gerAnti-NMDA-Rezeptor-NR1-Autoantikörperde
dc.subject.gerApoE4de
dc.subject.gerBlut-Hirn-Schrankede
dc.subject.gerSchizoaffektive Störungde
dc.subject.gerIschämischer Schlaganfallde
dc.subject.engAnti-NMDA-receptor subunit 1 autoantibodiesde
dc.subject.engApoE4de
dc.subject.engblood brain barrierde
dc.subject.engschizoaffective disorderde
dc.subject.engischemic strokede
dc.identifier.urnurn:nbn:de:gbv:7-11858/00-1735-0000-002E-E454-5-2
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullNeurologie - Allgemein- und Gesamtdarstellungen (PPN619876247)de
dc.subject.gokfullPsychiatrie (PPN619876344)de
dc.description.embargoed2018-07-26
dc.identifier.ppn102726008X


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