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Clinical significance of anti‐ DNA /N‐methyl‐D‐aspartate receptor 2 antibodies in de novo and post‐steroid cases with neuropsychiatric systemic lupus erythematosus
Author(s) -
Fujieda Yuichiro,
Mader Simone,
Jeganathan Venkatesh,
Arinuma Yoshiyuki,
Shimizu Yuka,
Kato Masaru,
Oku Kenji,
Minami Akiko,
Shimizu Chikara,
Yasuda Shinsuke,
Atsumi Tatsuya
Publication year - 2019
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13392
Subject(s) - antibody , autoantibody , immunology , medicine , systemic lupus erythematosus , anti nuclear antibody , receptor , anti dsdna antibodies , dna , biology , genetics , disease
Background Anti‐ DNA /N‐methyl‐D‐aspartate receptor 2 ( NR 2) antibodies (anti‐ DNA / NR 2 antibodies) are a subset of anti‐ DNA autoantibodies that cross‐react with the extracellular domain of the GluN2A/GluN2B subunits of NR 2. These antibodies induce apoptosis of hippocampus neurons and psychiatric disorder in mice and humans. Neuropsychiatric system lupus erythematosus ( NPSLE ) can develop after initiation of corticosteroids (post‐steroid neuropsychiatric manifestation: PSNP ) or before treatment (de novo NPSLE ); however, pathophysiological differences between these subtypes remain unclear. The objective of this study was to clarify the prevalence of anti‐ DNA / NR 2 antibodies in patients with NPSLE . Methods This study involved a cohort of patients with NPSLE admitted to our hospital. NPSLE patients were classified into two groups, de novo NPSLE and PSNP ‐ SLE . Serum anti‐ DNA antibodies and anti‐ DNA / NR 2 antibodies were measured by enzyme‐linked immunosorbent assays. Results Serum samples were obtained from 24 patients with de novo NPSLE , 25 with PSNP ‐ SLE and 76 healthy controls ( HC ). The level of anti‐ DNA / NR 2 antibodies in patients with de novo NPSLE and PSNP ‐ SLE were also higher than those in HC . Positive correlation between anti‐ DNA antibodies and anti‐ DNA / NR 2 antibodies were found in PSNP ‐ SLE , but was not significant in de novo NPSLE . Conclusion The levels of anti‐ DNA / NR 2 antibodies in PSNP ‐ SLE were similar to those in de novo NPSLE . Anti‐ DNA / NR 2 antibodies in PSNP ‐ SLE were suggested as a dominant subset of anti‐ DNA antibodies, indicating that anti‐ DNA / NR 2 antibodies may be a predictive factor in PSNP ‐ SLE .