The impact of anti-N-Methyl-D-Aspartate receptor antibodies on the clinical prognosis of major depressive disorder

2018 Fiscal Year Final Research Report

• Project/Area Number: 17K16377
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Psychiatric science
• Research Institution: Okayama University
• Principal Investigator: SAKAMOTO SHINJI 岡山大学, 大学病院, 助教 (30747093)
• Project Period (FY): 2017-04-01 – 2019-03-31
• Keywords: 抗NMDAR抗体 / 脳炎 / 気分障害 / うつ病 / グルタミン酸

Outline of Final Research Achievements

Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is increasingly recognized as one part of etiology about major depressive disorders, but there are few studies about the relationships between anti-NMDAR encephalitis and major depressive disorder. We firstly tested anti-NMDAR antibody in serum and cerebrospinal fluid of patients with mood disorder including major depressive disorder. Four of 64 patients (6.3%) had anti-NMDAR antibodies in cerebrospinal fluid.There was the weak correlation between titer of anti-NMDAR antibody in cerebrospinal fluid and severity of patients. We found that some patients who had been initially diagnosed with mood disorder had anti-NMDAR antibodies occasionally, because of the common pathophysiology as a dysfunction of the glutamatergic system.

Free Research Field

精神病態学

Academic Significance and Societal Importance of the Research Achievements

この研究により、うつ病という大きな社会的損失をもたらす精神疾患に対し、自己免疫という観点から生物学的基盤の解明と、それに基づいた革新的治療をもたらす可能性が示唆された。たとえば、抗NMDAR抗体脳炎に対して有効な抗炎症療法、抗免疫療法、抗腫瘍療法がうつ病患者に対しても有効となる可能性も考えられる。また、向精神薬や電気痙攣療法に反応不良な難治性うつ病患者においても抗NMDAR抗体を同定することで、新たな治療選択肢が増える可能性もある。以上のことから本研究は、うつ病の病態解明のみならず、うつ病患者に対する新たな治療法開拓の可能性を持った、社会的意義の大きな研究であると考える。