Anti-NMDA Receptor Encephalitis: Efficacy of Treatment for Male Patients and miRNA Biomarker

Treatments for the anti-NMDA receptor encephalitis usually include steroids, intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab, cyclophosphamide and tumor resection. We aimed to compare the efficacy of the treatments including intravenous immunoglobulin, plasma exchange, plasmapheresis, rituximab or cyclophosphamide for male anti-NMDA receptor encephalitis patients without tumor and to discuss potential biomarkers for this disease. The Fisher exact test and the contingency table analysis were used to analyze the treatment efficacy for both male and female these patients. A hierarchical tree method was adopted to analyze the difference of the treatment efficacy between male and female patients. The results revealed that the efficacy rate of plasmapheresis (or plasma exchange) is not inferior to those of intravenous immunoglobulin and rituximab (or cyclophosphamide) for male patients without tumor. In addition, B-cell attracting C-X-C motif chemokine 13 (CXCL13) and microRNA let-7b are potential to be treatment response biomarkers for anti-NMDA receptor encephalitis. But they may not be useful prognostic biomarkers for this encephalitis unless they are not biomarkers for other autoimmune encephalitides.