Spatial and Ecological Factors Modulate the Incidence of Anti-NMDAR Encephalitis—A Systematic Review

Autor: Agustí Alentorn, Giulia Berzero, Harry Alexopoulos, John Tzartos, Germán Reyes Botero, Andrea Morales Martínez, Sergio Muñiz-Castrillo, Alberto Vogrig, Bastien Joubert, Francisco A. García Jiménez, Dagoberto Cabrera, José Vladimir Tobon, Carolina Delgado, Patricio Sandoval, Mónica Troncoso, Lorna Galleguillos, Marine Giry, Marion Benazra, Isaias Hernández Verdin, Maëlle Dade, Géraldine Picard, Véronique Rogemond, Nicolas Weiss, Marinos C. Dalakas, Pierre-Yves Boëlle, Jean-Yves Delattre, Jérôme Honnorat, Dimitri Psimaras
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Biomedicines, Vol 11, Iss 6, p 1525 (2023)
Druh dokumentu: article
ISSN: 2227-9059
DOI: 10.3390/biomedicines11061525
Popis: Anti-NMDAR encephalitis has been associated with multiple antigenic triggers (i.e., ovarian teratomas, prodromal viral infections) but whether geographic, climatic, and environmental factors might influence disease risk has not been explored yet. We performed a systematic review and a meta-analysis of all published papers reporting the incidence of anti-NMDAR encephalitis in a definite country or region. We performed several multivariate spatial autocorrelation analyses to analyze the spatial variations in the incidence of anti-NMDA encephalitis depending on its geographical localization and temperature. Finally, we performed seasonal analyses in two original datasets from France and Greece and assessed the impact of temperature using an exposure-lag-response model in the French dataset. The reported incidence of anti-NMDAR encephalitis varied considerably among studies and countries, being higher in Oceania and South America (0.2 and 0.16 per 100,000 persons-year, respectively) compared to Europe and North America (0.06 per 100,000 persons-year) (p < 0.01). Different regression models confirmed a strong negative correlation with latitude (Pearson’s R = −0.88, p < 0.00001), with higher incidence in southern hemisphere countries far from the equator. Seasonal analyses showed a peak of cases during warm months. Exposure-lag-response models confirmed a positive correlation between extreme hot temperatures and the incidence of anti-NMDAR encephalitis in France (p = 0.03). Temperature analyses showed a significant association with higher mean temperatures and positive correlation with higher ultraviolet exposure worldwide. This study provides the first evidence that geographic and climatic factors including latitude, mean annual temperature, and ultraviolet exposure, might modify disease risk.
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