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作者

Heya Luan Xiaodong Han Chang Xu Aidi Shan Xin Wang Shaoqi Li Qi Yao Tong Cui Jinxuan Guo Boye Wen Yao Sun Chuqiao Li Qingyuan Sun Cuibai Wei

作者单位

²College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, China ¹Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun Street, Beijing 100053, China ³Jinan Hospital of Xuanwu Hospital, Shandong First Medical University, Jinan, China

刊名

The Journal of Prevention of Alzheimer's Disease

年份

2026

卷号

Vol.13 No.5

页码

100515

ISSN

2274-5807

关键词

Neuronal autoantibody Dementia Neurodegeneration Screening Clinical decision-making Autoimmune encephalitis

摘要

Neuronal autoantibodies, including against neuronal surface receptors or intracellular antigens, are established pathogenic mediators and therapeutic targets in autoimmune encephalitis and paraneoplastic neurological syndromes . These antibodies are now increasingly reported in patients with clinically diagnosed neurodegenerative dementia, prompting re-evaluation of a neurodegenerative etiology. Within neurodegenerative trajectories, whether such antibodies act as pathogenic drivers, non-causal...更多

Neuronal autoantibodies, including against neuronal surface receptors or intracellular antigens, are established pathogenic mediators and therapeutic targets in autoimmune encephalitis and paraneoplastic neurological syndromes . These antibodies are now increasingly reported in patients with clinically diagnosed neurodegenerative dementia, prompting re-evaluation of a neurodegenerative etiology. Within neurodegenerative trajectories, whether such antibodies act as pathogenic drivers, non-causal markers, or immune modulators remains unresolved, and heterogeneous cohorts, assays, and endpoints limit inference and clinical translation. This review integrates current research at the intersection of autoimmunity and neurodegeneration and highlights accumulating evidence for a biological continuum. This model suggests that antibody-mediated mechanisms may extend beyond acute inflammation, with sustained exposure contributing to time-dependent neurodegeneration. To facilitate clinical translation, we advance a standardized diagnostic workflow comprising three sequential stages: a pretest-probability triage that defines high-risk constellations prompting antibody testing, stratifies patients accordingly; a specimen-and-assay pathway for standardized testing workflow and structured interpretation of results; and post-test integrated analysis to adjudicate pathogenic relevance based on phenotype-antibody concordance. By bridging observational research to clinical decision-making, the framework supports identification of an immunologically modulated neurodegenerative subtype with potential for therapeutic intervention, while reducing false positives and avoiding non-essential immunotherapy in low-probability contexts.收起

文献类型

期刊