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Role of serum autoantibodies in blood brain barrier damages in neuropsychiatric systemic lupus erythematosus
S. Hirohata1, Y. Sakuma2, Y. Matsueda3, Y. Arinuma4, T. Yanagida5
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan. shunsei@med.kitasato-u.ac.jp
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan.
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan.
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan.
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
CER10814
2018 Vol.36, N°6
PI 1003, PF 1007
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PMID: 29846157 [PubMed]
Received: 15/09/2017
Accepted : 05/03/2018
In Press: 24/05/2018
Published: 06/12/2018
Abstract
OBJECTIVES:
The present study was carried out to elucidate the roles of serum autoantibodies in the development of blood-brain barrier (BBB) damages in neuropsychiatric systemic lupus erythematosus (NPSLE).
METHODS:
Paired serum and CSF samples were obtained from 101 SLE patients when they presented active neuropsychiatric manifestations (69 patients with diffuse psychiatric/neuropsychological syndromes [diffuse NPSLE] and 32 patients with neurologic syndromes or peripheral neuropathy [focal NPSLE]). IgG anti-NR2 subunit of NMDA receptor (anti-NR2), anti-Sm, anti-ribosomal P and IgG anti-cardiolipin in sera and albumin in CSF and sera were measured by ELISA. Blood-brain barrier (BBB) function was evaluated by Q albumin (CSF/serum albumin quotient x 1,000).
RESULTS:
Q albumin was significantly higher in acute confusional state (ACS) than in non-ACS diffuse NPSLE (anxiety disorder, cognitive dysfunction, mood disorder and psychosis) or in focal NPSLE. Anti-Sm, but not anti-NR2, anti-P or anticardiolipin, was significantly elevated in ACS compared with the other 2 groups of NPSLE, although serum anti-NR2 was significantly higher in ACS than that in focal NPSLE. Multiple regression analysis confirmed the significant contribution of anti-Sm (p=0.0040), but not anti-NR2 (p=0.5023), anti-P (p=0.2651), or anti-cardiolipin (p=0.6769) in the elevation of Q albumin.
CONCLUSIONS:
The data demonstrate that serum anti-Sm antibodies play a most important role in the disruption of BBB in NPSLE.