Anti-Neuronal Autoantibodies (Cell Surface and Onconeural) and Their Association With Natural Autoantibodies in Synthetic Cannabinoid-Induced Psychosis

Lídia Hau; Tamás Tényi; Natália László; Márton Áron Kovács; Szabina Erdö-Bonyár; Zsuzsanna Csizmadia; Tímea Berki; Diána Simon; Györgyi Csábi

doi:10.3389/fpsyt.2022.850955

Anti-Neuronal Autoantibodies (Cell Surface and Onconeural) and Their Association With Natural Autoantibodies in Synthetic Cannabinoid-Induced Psychosis

Front Psychiatry. 2022 May 2:13:850955. doi: 10.3389/fpsyt.2022.850955. eCollection 2022.

Authors

Lídia Hau¹, Tamás Tényi², Natália László¹, Márton Áron Kovács², Szabina Erdö-Bonyár³, Zsuzsanna Csizmadia³, Tímea Berki³, Diána Simon³, Györgyi Csábi¹

Affiliations

¹ Department of Pediatrics, Clinical Centre, University of Pécs Medical School, Pécs, Hungary.
² Department of Psychiatry and Psychotherapy, Clinical Center, University of Pécs Medical School, Pécs, Hungary.
³ Department of Immunology and Biotechnology, Clinical Center, University of Pécs Medical School, Pécs, Hungary.

Abstract

Patients suffering from encephalitis may present psychiatric symptoms; however, the clinical relevance of anti-neuronal antibodies in patients experiencing a psychotic episode without encephalitis is still unclear. In this study, we examined the presence of anti-neuronal cell surface autoantibodies and onconeural autoantibodies in serum samples of 22 synthetic cannabinoid users presenting with psychosis. We found only two positive cases; however, seven patients had borderline results. Nonetheless, we found no significant correlation between anti-neuronal autoantibodies and the intensity of psychosis indicated by the Positive and Negative Syndrome Scale (PANSS) scores. The length of drug use and the combination of other drugs with synthetic cannabinoids have no significant effect on anti-neuronal autoantibody positivity. Nonetheless, the ratio of anti-citrate synthase (anti-CS) IgM and IgG natural autoantibodies was significantly lower (p = 0.036) in the anti-neuronal autoantibody-positive/borderline samples, than in the negative group. Interestingly, anti-CS IgM/IgG showed a significant negative correlation with PANSS-positive score (p = 0.04, r = -0.464). Our results demonstrated that anti-neuronal autoantibody positivity occurs in synthetic cannabinoid users, and the alteration of anti-CS IgM/IgG natural autoantibody levels points to immunological dysfunctions in these cases.

Keywords: anti-citrate synthase antibodies; anti-neuronal autoantibodies; autoimmune encephalitis; natural autoantibodies; psychosis; synthetic cannabinoid.