Flow cytometric assessment of anti-neuronal antibodies in central nervous system involvement of systemic lupus erythematosus and other autoimmune diseases

Abstract

The objective of this study is to evaluate the association between anti-neuronal antibody (anti-NA) and central nervous system (CNS) manifestations of systemic lupus erythematosus (SLE) and other rheumatic diseases using a flow cytometric method. Anti-NA was measured by flow cytometry in serum and cerebrospinal fluid (CSF) samples from patients with SLE (n = 44 for serum, n = 17 for CSF), other rheumatic diseases (n = 64 for serum, n = 21 for CSF) and from healthy controls (n = 65 for serum, n = 18 for CSF). Serum anti-NA was more frequently observed in SLE (31.8%, 14/44) than in other rheumatic diseases (4.7%, 3/64, P < 0.001) or in healthy controls (0%, 0/65, P < 0.00001). In SLE patients, the frequency of serum anti-NA was significantly higher in CNS-SLE (76.5%, 13/17) than in non CNS-SLE (3.7%, 1/27, P < 0.000001). CSF anti-NA was detected in 88.2% (15/17) of CNS-SLE and was more frequently detected in CNS-SLE (15/17, 88.2%) than in other rheumatic diseases with CNS involvement (1/21, 4.8%, P < 0.000001) or in healthy controls (0/18, P < 0.000001). In conclusion, serum anti-NA was more frequently found in CNS-SLE than in non CNS-SLE, other rheumatic diseases or in healthy controls. The frequency of CSF anti-NA in CNS-SLE was significantly higher than in other rheumatic diseases with CNS involvement or in healthy controls. Lupus (2008) 17, 21—25.

Keywords

anti-neuronal antibody central nervous system lupus erythematosus systemic

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References

ACR ad hoc committee on neuropsychiatric lupus nomenclature. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 1999; 42: 599—608.

Wilson HA , Winfield JB , Lahita RG , Koffler D. Association of IgG anti-brain antibodies with central nervous system dysfunction in systemic lupus erythematosus. Arthritis Rheum 1979; 22: 458—462.

Bluestein HG , Williams GW , Steinberg AD Cerebrospinal fluid antibodies to neuronal cells: association with neuropsychiatric manifestations of systemic lupus erythematosus. Am J Med 1981; 70: 240—246.

Isshi K. , Hirohata S. Differential roles of the anti-ribosomal P antibody and antineuronal antibody in the pathogenesis of central nervous system involvement in systemic lupus erythematosus. Arthritis Rheum 1998; 41: 1819—1827.

Zhang X. , Shu H. , Zhang F. , Tian X. , Dong Y. Cell-ELISA detection of antineuronal antibodies in central nervous system involvement in systemic lupus erythematosus. Ann Rheum Dis 2007; 66: 530—532.

Kelly MC , Denburg JA Cerebrospinal fluid immunoglobulins and neuronal antibodies in neuropsychiatric systemic lupus erythematosus and related conditions. J Rheumatol 1987; 14: 740—744.

Long AA , Denburg SD , Carbotte RM , Singal DP , Denburg JA Serum lymphocytotoxic antibodies and neurocognitive function in systemic lupus erythematosus. Ann Rheum Dis 1990; 49: 249—253.

Toh B. , Mackay IR Autoantibody to a novel neuronal antigen in systemic lupus erythematosus and in normal human sera. Clin Exp Immunol 1981 ; 44: 555—559.

Klein R. , Richter C. , Berg PA Antibodies against central nervous system tissue (anti-CNS) detected by ELISA and western blotting: marker antibodies for neuropsychiatric manifestations in connective tissue diseases. Autoimmunity 1991; 10: 133—144.

10.

Hochberg MC Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997; 40: 1725.

11.

Alosachie IJ , Terryberry JW , Mevorach D. et al. Central nervous system (CNS) involvement in SLE. The diagnostic role of antibodies to neuronal antigens. Clin Rev Allergy Immunol 1998; 16: 275—284.

12.

Hanly JG Neuropsychiatric lupus. Curr Rheumatol Rep 2001; 3: 205—212.

13.

Bluestein HG Neurocytotoxic antibodies in serum of patients with systemic lupus erythematosus. Proc Natl Acad Sci U S A 1978; 75: 3965—3969.