Immunotherapy for Refractory Autoimmune Encephalitis

Front Immunol. 2021 Dec 16:12:790962. doi: 10.3389/fimmu.2021.790962. eCollection 2021.

Abstract

Autoimmune encephalitis (AE) is an immune-mediated disease involving the central nervous system, usually caused by antigen-antibody reactions. With the advent of autoantibody-associated diseases, AE has become a hot research frontier in neuroimmunology. The first-line conventional treatments of autoimmune encephalitis consist of steroids, intravenous immunoglobulin (IVIG), plasma exchange (PLEX), and second-line therapy includes rituximab. Despite considerable research and expanding clinical experience, current treatments are still ineffective for a significant number of patients. Although there is no clear consensus, clinical trial evidence limited, and the level of evidence for some of the drugs based on single reports, third-line therapy is a viable alternative for refractory encephalitis patients. With the current rapid research progress, a breakthrough in the treatment of AE is critical. This article aims to review the third-line therapy for refractory AE.

Keywords: autoimmune encephalitis; neuroimmunology; refractory; rituximab; third-line therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / therapy*
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Drug Resistance
  • Humans
  • Immunoglobulins, Intravenous / pharmacology
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / pharmacology*
  • Immunologic Factors / therapeutic use
  • Immunotherapy / methods*
  • Limbic Encephalitis / immunology
  • Limbic Encephalitis / therapy*
  • Plasma Exchange*
  • Rituximab / pharmacology
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Rituximab

Supplementary concepts

  • Autoimmune limbic encephalitis