1. Prevalence of Neural Autoantibodies in Epilepsy of Unknown Etiology: Systematic Review and Meta-Analysis
- Author
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Cabezudo-García, Pablo, Mena-Vázquez, Natalia, Ciano-Petersen, Nicolás L., García-Martín, Guillermina, Estivill-Torrús, Guillermo, Serrano-Castro, Pedro J., [Cabezudo-García,P, Mena-Vázquez,N, Ciano-Petersen,NL, García-Martín,G, Estivill-Torrús,G, Serrano-Castro,PJ] Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain. [Cabezudo-García,P, Serrano-Castro,PJ] Unidad de Gestión Clínica de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain. [Mena-Vázquez,N] Unidad de Gestión Clínica de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain., and Grant for medical Research. Fundación Española de Reumatología. N.M.-V.
- Subjects
Anticuerpos ,Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Epilepsy [Medical Subject Headings] ,Receptores de glicina ,Neural autoantibodies ,Glycine receptor ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Glycoproteins::Membrane Glycoproteins::Cell Adhesion Molecules::Cell Adhesion Molecules, Neuronal::Contactins [Medical Subject Headings] ,Antibodies ,Epilepsia ,Persons::Persons::Age Groups::Adolescent [Medical Subject Headings] ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Prevalence ,Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Nerve Tissue::Neuroectodermal Tumors::Neoplasms, Neuroepithelial::Glioma [Medical Subject Headings] ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Carrier Proteins::Membrane Transport Proteins::Ion Channels::Chloride Channels::Receptors, Glycine [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings] ,Autoimmune epilepsy ,Glutamato descarboxilasa ,Autoantibodies ,Glutamic acid decarboxylase ,Epilepsy ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Meta-Analysis as Topic [Medical Subject Headings] ,Autoanticuerpos ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Amino Acids::Amino Acids, Branched-Chain::Leucine [Medical Subject Headings] ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Carrier Proteins::Membrane Transport Proteins::Ion Channels::Ligand-Gated Ion Channels::Receptors, Ionotropic Glutamate::Receptors, N-Methyl-D-Aspartate [Medical Subject Headings] ,Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Lyases::Carbon-Carbon Lyases::Carboxy-Lyases::Glutamate Decarboxylase [Medical Subject Headings] ,Prevalencia ,Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Autoantibodies [Medical Subject Headings] - Abstract
Background: The prevalence of neural autoantibodies in epilepsy of unknown etiology varies among studies. We aimed to conduct a systematic review and meta-analysis to determine the pooled global prevalence and the prevalence for each antibody. Methods: A systematic search was conducted for studies that included prospectively patients ≥16 years old with epilepsy of unknown etiology and systematically determined neural autoantibodies. A meta-analysis was undertaken to estimate pooled prevalence in total patients with a positive result for at least one neural autoantibody in serum and/or cerebrospinal fluid (CSF) and for each autoantibody. Results: Ten of the eleven studies that met the inclusion criteria and a total of 1302 patients with epilepsy of unknown etiology were included in themeta-analysis. The global pooled prevalence (IC95%) was 7.6% (4.6–11.2) in a total of 82 patients with a positive result for any neural autoantibody. None of the controls available in the studies had a positive result. Individual pooled prevalence for each autoantibody was: glycine receptor (GlyR) (3.2%), glutamic acid decarboxylase (GAD) (1.9%), N-methyl-d-aspartate receptor (NMDAR) (1.8%), leucine-rich glioma inactivated-1 protein (LGI1) (1.1%), contactin-2-associated protein (CASPR2) (0.6%) and onconeuronal (0.2%). Conclusions: The pooled prevalence of neural autoantibodies in patients with epilepsy of unknown etiology is small but not irrelevant. None of the controls had a positive result. There was high heterogeneity among studies. In the future, a homogeneous protocol for testing neural autoantibodies is recommended. Yes
- Published
- 2021