Key words: neuroimmunology, autoantibodies, myasthenia gravis, psychosis, therapeutic strategies

"Autoantibodies in the nervous system: pathophysiology and new therapeutic strategies"

The immune system is a complex network that protects the body against pathogens by eliminating external harmful agents such as viruses, bacteria or fungi. However, when the balance within the immune system gets disrupted, antibodies that recognize and attack different molecules within our body are produced, resulting in autoimmunity. Antibody-mediated autoimmune diseases affect more than 2.5% of the general population, contributing substantially to morbidity, mortality, and annual health care cost, a percentage that has increased over the past decades. The disease mechanisms of psychotic disorders are unknown. However, psychosis is a common symptom in many disorders, including some caused by autoantibodies. Therefore, we investigated the prevalence of autoantibodies against neuronal proteins in psychotic patients. Even though it seems to be rare, the identification and characterization of these autoantibodies will help to gain knowledge on the disease mechanisms and guarantee an accurate diagnosis. In other autoimmune disorders such as in myasthenia gravis, the target and the mechanisms of action of the autoantibodies are well characterized. The study of the specific role of the different proteins involved in the disease and weather they provide resistance or susceptibility to the disease can be used to design and develop specific treatment strategies. Knowledge gives the opportunity to investigate the efficacy of repurposed drugs, which in the case of proteasome inhibitors, presented with a stunning beneficial effect using different models of myasthenia gravis. The comprehension of the disease mechanisms underlying autoimmunity provides the tools to design and develop new treatment strategies, with increased specificity, circumventing the effects of systemic immune suppression and increasing tolerability.