Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a potentially severe autoimmune encephalitis that may rapidly progress to critical illness. We report a young patient with severe anti-NMDAR encephalitis complicated by seizures, psychiatric symptoms, behavioral disturbance, dyskinesia, and dysautonomia. Despite first-line immunotherapy with intravenous methylprednisolone and intravenous immunoglobulin, the patient remained severely disabled. Peripheral blood analysis showed elevated C5a and soluble C5b-9 levels, suggesting activation of the terminal complement pathway. After treatment with eculizumab, a monoclonal antibody targeting complement component C5, seizure ceased and psychiatric symptoms improved rapidly. These findings suggest that complement inhibition may facilitate rapid neurological recovery and may represent a potential therapeutic strategy for selected patients with severe anti-NMDAR encephalitis.
Yang Liu, Yujing Yuan, Yingjie Zhang et al.· Journal of Neuroimmunology· 0 citations
Pathogenic variants in SGCA, encoding α-sarcoglycan, cause an autosomal recessive limb-girdle muscular dystrophy, LGMDR3/2D, yet clinical interpretation of SGCA variants remains challenging due to the high prevalence of rare missense variants. α-sarcoglycan is an essential component of the sarcoglycan complex at the muscle cell membrane, and pathogenic variants frequently impair its membrane localization. Here, we systematically assess the effects of all possible single-nucleotide variants across the SGCA coding sequence using a saturation mutagenesis-based experimental assay that quantifies α-sarcoglycan surface expression. We generate a comprehensive functional atlas that distinguishes tolerated and damaging variants, aligning with independent genetic and clinical evidence, and reveals domain-specific properties of the cytoplasmic region, in which C-terminal truncating variants retain membrane localization, suggesting possible pathogenic mechanisms beyond impaired trafficking. This work provides a scalable functional framework to support genetic diagnosis and variant interpretation in sarcoglycanopathies. Graphical Abstract Schematic overview of saturation mutagenesis-based functional mapping of SGCA.
Shushu Huang, Kenneth K. Ng, Yanyu Lu et al.· bioRxiv· 0 citations
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