Association of serum Gasdermin D with anti‐N‐methyl‐D‐aspartate receptor encephalitis
Xiaoyu Ma, Chen Chen, Yaxin Lu, Ling Fang, Baohua Cao, Xueqiang Hu, Wei Qiu, Yaqing Shu
Abstract
Abstract Anti‐N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis is an autoimmune disease of the central nervous system. Gasdermin D (GSDMD) is associated with autoimmune disorders and neuroinflammatory disorders, but its role in anti‐NMDAR encephalitis is unclear. In this study, we measured serum levels of GSDMD in 42 patients with anti‐NMDAR encephalitis and 25 healthy controls. Of the 42 patients, 17 had follow‐up evaluation of GSDMD levels and modified Rankin scale (mRS) scores at 3 months. Association of GSDMD with anti‐NMDAR encephalitis and its clinical parameters were evaluated. Serum GSDMD levels were significantly higher in patients with anti‐NMDAR encephalitis than in healthy controls ( p = 0.002, p adjusted = 0.009), especially in males ( p = 0.001, p adjusted = 0.022). This was also evident in patients with severe impairment (mRS >3 vs mRS ≤3; p < 0.001). Serum GSDMD was associated with mRS before and after adjustment for age and gender ( r = 0.440 and 0.430, p = 0.004 and 0.006, respectively) as well as serum CH50 ( r = −0.419 and −0.426, p = 0.011 and 0.012, respectively). Furthermore, 3‐month follow‐up evaluation revealed that after treatment, anti‐NMDAR encephalitis patients had significantly decreased serum GSDMD levels ( p = 0.007) and significantly decreased mRS scores ( p = 0.002) compared with before treatment. Furthermore, the changes in mRS scores were negatively associated with changes in GSDMD levels, although the associations were not significant ( r = −0.222, p = 0.393). Our findings show that serum GSDMD levels are elevated in anti‐NMDAR encephalitis and are associated with disease prognosis. image