Detection of serum of IgG anti-neuronal antibodies in systemic lupus erythematosus patients with central nervous system manifestations.
Detection of serum of IgG anti-neuronal antibodies in systemic lupus erythematosus patients with central nervous system manifestations.
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发表时间：
2010
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通讯作者：
I. Cojocaru;M. Cojocaru;Ludmila Botnaru;Gabriela Miu;V. Sapira;R. Tanasescu
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作者：
I. Cojocaru;M. Cojocaru;Ludmila Botnaru;Gabriela Miu;V. Sapira;R. Tanasescu
本研究的目的是评估血清IgG抗神经元抗体（NA）的频率在SLE患者中枢神经系统表现。对47例有中枢神经系统表现的系统性红斑狼疮（CNS-SLE）患者（年龄33-52岁，平均年龄38.6岁，男18例，女29例）和31例无中枢神经系统表现的SLE患者（年龄28-56岁，平均年龄41.2岁，男13例，女18例）及56例健康人进行了血清抗NA抗体检测。间接免疫荧光法测定血清IgG抗神经元抗体。47例CNS-SLE患者中有35例（74.6%）出现抗NA。15例急性意识模糊患者中有15例（100%）、8例脑血管病患者中有8例（100%）、7例癫痫发作患者中有5例（76.3%）、5例顽固性头痛患者中有4例（86.8%）抗NA阳性。在31例非CNS-SLE患者中，1例患者出现抗NA（3.9%）。与对照组相比，在CNS-SLE患者中更频繁地观察到血清抗NA（p < 0.000001）。CNS-SLE患者血清抗NA抗体阳性率显著高于非CNS-SLE患者（P < 0.00001）。总之，血清抗神经元抗体与中枢神经系统性红斑狼疮有关。这些抗体在CNS-SLE患者中比非CNS-SLE患者更常见，表明血清抗NA抗体与SLE的CNS受累之间存在强相关性。血清中抗NA抗体的检测可作为CNS-SLE的诊断工具，有助于SLE与其他症状相似的疾病的鉴别。抗NA抗体对SLE的预测价值有待进一步研究。
The objective of the study was to assess the frequence of serum IgG anti-neuronal antibodies (NA) in SLE patints with CNS manifestations. Serum anti-NA antibodies were measured in 47 patients with SLE with CNS manifestations (CNS-SLE), age 33-52 years, mean age 38.6 years, 18 men and 29 women, as compared to 31 patients with SLE without CNS manifestations, age 28-56 years, mean age 41.2 years, 13 men and 18 women and 56 healthy subjects. Serum IgG antineuronal antibodies were measured by indirect immunofluorescent assay. Thirty-five of out 47 CNS-SLE patients presented anti-NA (74.6%). Anti-NA were observed in 15 out of 15 patients with acute confusional state (100%), in 8 of 8 patients with cerebrovascular disease (100%), in 5 out of 7 patients with seizure disorder (76.3%), and in 4 out of 5 patients in intractable headache (86.8%). Out of 31 nonCNS-SLE patients 1 patient presented anti-NA (3.9%). Serum anti-NA were more frequently observed in CNS-SLE patients as compared to controls (p < 0.000001). The frequence of serum anti-NA was significantly higher in CNS-SLE patients as compared to non CNS-SLE patients (p < 0.00001). In conclusion, serum anti-neuronal antibodies are associated with CNS-SLE. These antibodies are more frequent in CNS-SLE than in nonCNS-SLE patients, demonstrating a strong association between serum anti-NA and CNS involvement of SLE. The presence of serum anti-NA could be a useful diagnostic tool for CNS-SLE, the test could help to distinguish SLE from other diseases with similar symptoms. Further studies are needed to evaluate the predictive value of anti-NA in SLE.