{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T16:58:03Z","timestamp":1781283483680,"version":"3.54.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The role of antineuronal antibody titres in the acute and long-term diagnostic and therapeutic management of autoimmune encephalitis (AE) remains unclear. In this retrospective monocentric cohort study, we aimed to (I) identify specific characteristics in antibody testing distinguishing AE from non-AE patients, (II) evaluate the prognostic significance of antineuronal antibody findings and (III) assess outcomes and long-term immunotherapy in patients with AE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with suspected autoimmune-associated neuropsychiatric conditions underwent antineuronal antibody testing between 01\/2017 and 03\/2023. Patients with positive antibody tests were stratified into AE and non-AE groups based on the clinical criteria proposed by Graus and colleagues. Long-term outcomes, antibody titres, and therapeutic strategies were analysed in AE patients over a three-year follow-up period. Among 2,466 patients tested, 53 met the diagnostic criteria for AE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In AE patients with paired serum and CSF samples (n = 44), antibodies were detectable in both serum and CSF in 55% of cases (n = 24), in serum only in 36% (n = 16), and in CSF only in 9% (n = 4). AE patients with poor outcomes (n=5) showed a trend toward higher median CSF titres in the acute phase and at four months post-onset compared to patients with good outcomes (n=14); however, differences were not statistically significant. Regarding long-term immunotherapy, rituximab-treated patients experienced fewer relapses than those receiving intravenous-immunoglobulins (IVIG; p-value = 0.02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These exploratory results from a small, heterogeneous cohort require confirmation in larger, prospective studies. Based on our data regarding serum and CSF antibodies, in a resource- limited setting we propose a stepwise diagnostic approach starting with serum screening; in suspected anti-NMDAR-AE, initial paired serum\/CSF testing remains essential. If antibodies are detected in serum, additional CSF antibody testing may provide diagnostic confirmation and help guide treatment decisions, as high acute-phase CSF titres may suggest poorer long-term outcomes; however, this potential prognostic value requires confirmation in larger, antibody-specific studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1771609","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:30:45Z","timestamp":1773120645000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Antineuronal antibody titres in autoimmune encephalitis: clinical implications for diagnosis and long-term immunotherapy"],"prefix":"10.3389","volume":"17","author":[{"given":"Hanna","family":"Schwab","sequence":"first","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research and Hertie Center of Neurology, University and University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josua","family":"Kegele","sequence":"additional","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research and Hertie Center of Neurology, University and University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus C.","family":"Kowarik","sequence":"additional","affiliation":[{"name":"Department of Neurology and Vascular Diseases, Hertie Institute for Clinical Brain Research and Hertie Center of Neurology, University and University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Lerche","sequence":"additional","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research and Hertie Center of Neurology, University and University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Lauxmann","sequence":"additional","affiliation":[{"name":"Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research and Hertie Center of Neurology, University and University Hospital T\u00fcbingen","place":["T\u00fcbingen, Germany"]},{"name":"Neurocenter Klinikverbund S\u00fcdwest","place":["B\u00f6blingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12553","article-title":"Autoimmune encephalopathies","volume":"1338","author":"Leypoldt","year":"2015","journal-title":"Ann New York Acad Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1136\/jnnp-2020-325300","article-title":"Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management","volume":"92","author":"Abboud","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9","article-title":"A clinical approach to diagnosis of autoimmune encephalitis","volume":"15","author":"Graus","year":"2016","journal-title":"Lancet Neurol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2022.12.029","article-title":"Antineuronal antibodies in cerebrospinal fluid and serum of 104 patients with psychotic disorders compared to 104 individually matched healthy controls","volume":"252","author":"Jeppesen","year":"2023","journal-title":"Schizophr Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.654602","article-title":"Neural autoantibodies in cerebrospinal fluid and serum in clinical high risk for psychosis, first-episode psychosis, and healthy volunteers","volume":"12","author":"Bien","year":"2021","journal-title":"Front Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09814-3","article-title":"Routine diagnostics for neural antibodies, clinical correlates, treatment and functional outcome","volume":"267","author":"6. 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