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Overlaps in clinical course in addition to epidemiological and genetic associations raise the possibility that autoimmune mechanisms may underlie some psychoses, potentially offering novel therapeutic approaches. Several immune loci including the major histocompatibility complex and B\u2010cell markers <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>19 and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>20 achieve genome\u2010wide significance in schizophrenia. Emerging evidence suggests a potential role via neurodevelopment in addition to classical immune pathways. Additionally, lymphocyte biology is increasingly investigated. Some reports note raised peripheral <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>19<jats:sup>+<\/jats:sup> and reduced <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>3<jats:sup>+<\/jats:sup> lymphocyte counts, with altered <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 : CD8 ratios in acute psychosis. Also, post\u2010mortem studies have found <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>3<jats:sup>+<\/jats:sup> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>20<jats:sup>+<\/jats:sup> lymphocyte infiltration in brain regions that are of functional relevance to psychosis. More specifically, the recent paradigm of neuronal surface antibody\u2010mediated (<jats:styled-content style=\"fixed-case\">NSA<\/jats:styled-content>b) central nervous system disease provides an antigen\u2010specific model linking adaptive autoimmunity to psychopathology. <jats:styled-content style=\"fixed-case\">NSA<\/jats:styled-content>bs bind extracellular epitopes of signalling molecules that are classically implicated in psychosis such as <jats:styled-content style=\"fixed-case\">NMDA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> receptors. This interaction may cause circuit dysfunction leading to psychosis among other neurological features in patients with autoimmune encephalitis. The detection of these cases is crucial as autoimmune encephalitis is ameliorated by commonly available immunotherapies. Meanwhile, the prevalence and relevance of these antibodies in people with isolated psychotic disorders is an area of emerging scientific and clinical interest. Collaborative efforts to achieve larger sample sizes, comparison of assay platforms, and placebo\u2010controlled randomized clinical trials are now needed to establish an autoimmune contribution to psychosis.<\/jats:p>","DOI":"10.1111\/imm.12795","type":"journal-article","created":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T17:22:53Z","timestamp":1499966573000},"page":"388-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":104,"title":["Psychosis: an autoimmune disease?"],"prefix":"10.1111","volume":"152","author":[{"given":"Adam A. 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