Immunopathological characterization of ovarian teratomas associated with anti-N-methyl-D-aspartate receptor encephalitis.
Anti-NMDAR encephalitis
Autoimmunity
Ovarian teratoma
Journal
Acta neuropathologica communications
ISSN: 2051-5960
Titre abrégé: Acta Neuropathol Commun
Pays: England
ID NLM: 101610673
Informations de publication
Date de publication:
11 03 2019
11 03 2019
Historique:
received:
14
02
2019
accepted:
05
03
2019
entrez:
13
3
2019
pubmed:
13
3
2019
medline:
31
3
2020
Statut:
epublish
Résumé
Encephalitis with anti-NMDAR antibodies (NMDAR-E) is a severe autoimmune neurological disorder, defined by a clinical presentation of encephalitis and the presence of IgG targeting the GluN1 subunit of NMDA receptors in the CSF. An underlying ovarian teratoma is commonly associated with this autoimmune disease suggesting a role of the tumor in immunopathogenesis. In this study, we characterized the salient histopathological features of 27 ovarian teratomas associated with NMDAR-E (3 immature and 24 mature teratomas) and 40 controls without associated encephalitis. All but one NMDAR-E-associated teratomas contained a nervous tissue component, while less than 40% of control teratomas did (p < 0.001). GluN1 expression by teratomatous nervous tissue seemed to be more often glial in NMDAR-E teratomas than in control teratomas (73% vs. 29%, p < 0.05). Strikingly, 3 out of 24 NMDAR-E-associated mature teratomas contained neuroglial tissue exhibiting histopathological features of central nervous system neuroglial tumor, while such glioma-like features are exceptionally described in the literature on ovarian teratomas. Moreover, NMDAR-E associated teratomas differed from sporadic ovarian teratomas by consistent and prominent infiltration of the nervous tissue component by immune cells, comprised of T- and B-cells and mature dendritic cells organized in tertiary lymphoid structures, with IgG and IgA deposits and plasma cells in close contact to the neuroglial tissue.These data demonstrate an association between massive infiltration of NMDAR-E-associated teratomas by immune cells and particular glial features of its neuroglial component, suggesting that this glial tissue might be involved in triggering or sustaining the anti-tumor response associated with the auto-immune neurological disease.
Identifiants
pubmed: 30857565
doi: 10.1186/s40478-019-0693-7
pii: 10.1186/s40478-019-0693-7
pmc: PMC6410529
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
38Subventions
Organisme : Ligue Contre le Cancer
ID : Comité du Rhône
Pays : International
Organisme : Ligue Contre le Cancer
ID : Comité de Savoie
Pays : International
Organisme : Fondation pour la recherche médicale (FR)
ID : DQ20170336751
Pays : International
Organisme : Agence Nationale de la Recherche
ID : ANR-14-CE15-0001-MECANO
Pays : International
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