In:
Arthritis & Rheumatology, Wiley, Vol. 70, No. 2 ( 2018-02), p. 277-286
Kurzfassung:
IgG anti‐ DWEYS antibodies cross‐reactive with DNA and the N ‐methyl‐ d ‐aspartate receptor subunits GluN2A and GluN2B are known to be associated with neuropsychiatric systemic lupus erythematosus ( NPSLE ). IgG anti‐ DWEYS have not been investigated in demyelinating NPSLE or in another demyelinating disorder, neuromyelitis optica spectrum disorder ( NMOSD ), which is a disease also found mainly in young women and associated with aquaporin 4 ( AQP ‐4) or myelin oligodendrocyte glycoprotein ( MOG ) antibodies. This study was undertaken to investigate the frequency of all of these brain‐reactive antibodies in patients with NPSLE , those with demyelinating NPSLE , and those with NMOSD . Methods Serum samples from patients with NPSLE (n = 108), patients with SLE without neuropsychiatric manifestations (n = 38), patients with NMOSD (n = 33), and healthy controls (n = 106) were assessed for the frequency of IgG anti‐brain antibodies as well as IgG antibodies to AQP ‐4, MOG , GluN2A/GluN2B, and double‐stranded DNA (ds DNA ). Results Sera were positive for IgG anti– AQP ‐4 antibodies in 27 (82%) of 33 patients with NMOSD and 3 (27%) of 11 patients with demyelinating NPSLE , whereas all sera from patients with non‐demyelinating NPSLE , patients with SLE , and healthy controls were negative for IgG anti– AQP ‐4. IgG anti‐ MOG were detected at high titers in 3 (50%) of 6 patients with NMOSD who were negative for IgG anti– AQP ‐4, and at low titers in 2 (18%) of 11 patients with demyelinating NPSLE and 1 (1%) of 97 patients with non‐demyelinating NPSLE . IgG antibodies to ds DNA were present in 11 (33%) of 33 patients with NMOSD . Only 4 (12%) of 33 patients with NMOSD were positive for IgG anti‐ DWEYS , compared to 11 (29%) of 38 patients with SLE and 59 (55%) of 108 patients with NPSLE . IgG anti‐ DWEYS antibodies were present in 56 (58%) of 97 patients with non‐demyelinating NPSLE and 3 (27%) of 11 patients with demyelinating NPSLE . Serum IgG brain‐reactive antibodies were present at a similar frequency in patients with non‐demyelinating NPSLE (72 [75%] of 96), those with demyelinating NPSLE (9 [82%] of 11), and those with SLE (32 [84%] of 38), but were less frequent in patients with NMOSD (20 [61%] of 33). Conclusion Patients with demyelinating NPSLE should be tested for IgG antibodies to AQP ‐4, MOG , and DWEYS . IgG anti– AQP ‐4 can be considered diagnostic for NMOSD , whereas none of these antibodies appear to be diagnostic for demyelinating NPSLE . Moreover, IgG anti‐ds DNA are present in patients with NMOSD but are not cross‐reactive with IgG anti‐ DWEYS , indicating that the antigenic stimulus and mechanisms of tissue damage are potentially different between demyelinating NPSLE and NMOSD .
Materialart:
Online-Ressource
ISSN:
2326-5191
,
2326-5205
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2018
ZDB Id:
2754614-7
