抗体相关脑炎是一类以神经精神症状为主要临床表现、针对神经元细胞膜表面或细胞内抗原的抗体相关性自身免疫性疾病。根据抗原位置的不同、抗体的致病作用以及对免疫治疗的反应性，抗体相关脑炎可以分为自身免疫性脑炎（autoimmune encephalitis，AE）和副肿瘤综合征（paraneoplastic syndrome，PS）。本文聚焦于抗体相关脑炎的免疫致病机制，探讨发病的诱因、免疫耐受失败、致病抗体的产生及其破坏作用以及血脑屏障的损害等，旨在促进对AE与PS致病机制及治疗原则差异的认识，为自身免疫性脑炎治疗方案的优化提供参考依据。

Antibody-related encephalitis refers to an autoimmune inflammatory brain disease associated with antibodies against neuronal cell-surface or intracellular antigens, which takes neuropsychiatric symptoms as the main clinical manifestations. According to the antigen location, the pathogenicity of antibody and the response to immunotherapy, antibody-related encephalitis can be roughly divided into autoimmune encephalitis (AE) and paraneoplastic syndrome (PS). This review highlights the immunological pathogenesis of antibody-related encephalitis, including the causes of onset, failure of immunologic tolerance, the generation and damaging effects of pathogenic antibodies, and the destruction of blood-brain barrier, and aims to further understand the differences in pathogenesis treatment principles between AE and PS to provide evidences for further treatment optimization.