Immunotherapy for Refractory Autoimmune Encephalitis

• Published in: Frontiers in immunology Vol. 12; p. 790962
• Main Authors: Yang, Jiawei, Liu, Xueyan
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16.12.2021
• Subjects: Animals; Autoimmune Diseases - immunology; Autoimmune Diseases - therapy; autoimmune encephalitis; Clinical Trials as Topic; Disease Models, Animal; Drug Resistance; Humans; Immunoglobulins, Intravenous - pharmacology; Immunoglobulins, Intravenous - therapeutic use; Immunologic Factors - pharmacology; Immunologic Factors - therapeutic use; Immunology; Immunotherapy - methods; Limbic Encephalitis - immunology; Limbic Encephalitis - therapy; neuroimmunology; Plasma Exchange; refractory; rituximab; Rituximab - pharmacology; Rituximab - therapeutic use; third-line therapy; Treatment Outcome; autoimmune encephalitis; third-line therapy; refractory; neuroimmunology; rituximab
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2021.790962

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