{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:05:59Z","timestamp":1789499159308,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a novel autoimmune disease of central nervous system (CNS). It is unclear whether Epstein\u2013Barr virus (EBV) is related to autoimmune GFAP astrocytopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the clinical, laboratory, and imaging characteristics of patients with autoimmune GFAP astrocytopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical, laboratory, and imaging findings of patients are presented. The levels of GFAP in CSF were detected by ELISA. T and B cell subsets in CSF were detected by flow cytometry. GFAP\u2010IgG in serum and cerebrospinal fluid (CSF) were tested by cell\u2010based assay (CBA) and tissue\u2010based assay (TBA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All three patients had fever, cognitive dysfunction, limb weakness, and positive GFAP\u2010IgG with EBV infection in CSF. Enteric glia cells may involve in this disease. Typical imaging findings include the gadolinium enhancement of linear perivascular radial perpendicular to the ventricle, meningeal enhancement (especially in midbrain interpeduncal fossa), longitudinally extensive lesions involving spindle cords, and more T2\/Flair\u2010hyperintense lesions in the periventricular white matter at late stage. The patients had poor response to antiviral treatment and strong response to steroid pulse therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>EBV could induce CNS autoimmune response in autoimmune GFAP astrocytopathy. The detection of GFAP\u2010IgG and EBV may facilitate the early diagnosis in these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14336","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T09:59:16Z","timestamp":1689587956000},"page":"4139-4146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Epstein\u2013Barr virus: To be a trigger of autoimmune glial fibrillary acidic protein astrocytopathy?"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-7099","authenticated-orcid":false,"given":"Xiao\u2010Li","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"Department of Neurology, Shandong Provincial Qianfoshan Hospital Cheeloo College of Medicine, Shandong University  Jinan China"},{"name":"Shandong Institute of Neuroimmunology  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang\u2010Kang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shandong Provincial Qianfoshan Hospital Cheeloo College of Medicine, Shandong University  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"Department of Neurology, Shandong Provincial Qianfoshan Hospital Cheeloo College of Medicine, Shandong University  Jinan China"},{"name":"Shandong Institute of Neuroimmunology  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue\u2010Lu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"Department of Neurology, Shandong Provincial Qianfoshan Hospital Cheeloo College of Medicine, Shandong University  Jinan China"},{"name":"Shandong Institute of Neuroimmunology  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital  Jinan China"},{"name":"Department of Neurology, Shandong Provincial Qianfoshan Hospital Cheeloo College of Medicine, Shandong University  Jinan China"},{"name":"Shandong Institute of Neuroimmunology  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Shandong First Medical University &amp; 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