Association of cerebrospinal fluid anti-ribosomal P protein antibodies with diffuse psychiatric/neuropsychological syndromes in systemic lupus erythematosus |
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Authors: | Shunsei Hirohata Yoshiyuki Arinuma Maki Takayama Taku Yoshio |
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Institution: | (1) Department of Rheumatology and Infectious Disease, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara Kanagawa, 228-8555, Japan;(2) Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku Tokyo, 173-8605, Japan;(3) Division of Rheumatology and Clinical Immunology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke Tochigi, 329-0498, Japan |
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Abstract: | We explored the relationship of antibodies to the whole ribosomal P proteins (P0, P1, and P2) in cerebrospinal fluid (CSF)
with diffuse psychiatric/neuropsychological syndromes in systemic lupus erythematosus (SLE). CSF samples were obtained from
71 SLE patients (52 patients with diffuse psychiatric/neuropsychological syndromes diffuse NP-SLE] and 19 patients with neurological
syndromes or peripheral neuropathy focal NP-SLE]) as well as from 24 patients with non-inflammatory neurological disease.
Immunoglobulin G (IgG) antibodies to the C-terminal 22-amino acid ribosomal P synthetic peptide (anti-PC22) and those to purified bovine ribosomal P proteins (P0, P1, and P2) (anti-whole P) were determined by enzyme-linked immunosorbent
assay; affinity-purified IgG anti-PC22 were used as the standard. The concentrations of antibodies to epitopes other than the C-terminal 22 amino acids of ribosomal
P proteins were calculated by subtracting anti-PC22 from anti-whole P (anti-PEX.C22). CSF anti-whole P levels were significantly elevated in diffuse NP-SLE compared with focal NP-SLE or control patients. By
contrast, there were no significant differences in CSF anti-PC22 levels among the three groups. Of note, CSF anti-PEX.C22 levels were significantly elevated in diffuse NP-SLE compared with the other two groups. CSF anti-PEX.C22 levels were not significantly correlated with CSF anti-PC22 levels, but with CSF antibodies against the recombinant ribosomal P0 protein lacking the C-terminal 22 amino acids (C22-depleted
rP0). Moreover, levels of CSF anti-PEX.C22 or CSF anti-C22-depleted rP0, but not CSF anti-PC22, were significantly correlated with CSF anti-neuronal cell antibodies (anti-N). These results indicate that CSF IgG antibodies
to the epitopes other than the C-terminal 22 amino acids of ribosomal P proteins, which might contain one of the major targets
of CSF anti-N, are associated with the development of diffuse NP-SLE. |
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