Figure 1.

Workflow integrating anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis gut microbiome, fecal and serum metabolomes, and cytokines. Fifty-eight patients with a definite diagnosis of NMDAR encephalitis were divided into different severity groups: severe (n = 22) and moderate (n = 36); there were 49 healthy controls. We next constructed a co-abundance network with 294 operational taxonomic units (OTUs) and clustered them into 19 co-abundance groups (CAGs). Subsequently, we identified the important CAGs that were strikingly prevalent in patients with more severe status. We then identified the serum and fecal metabolome and cytokine features between NMDAR encephalitis patients and healthy controls. Serum and fecal metabolites were summarized as co-abundance metabolic modules. Next, we identified the relationships between the markedly altered gut microbiome composition, host metabolic profiles, and the major dysregulated cytokines. Finally, fecal and serum samples from 30 patients after 6 months of follow-up were collected to investigate longitudinal deviations in dysbiosis and establish associations between disease outcome markers and dysbiosis.