抄録
Objective: Development of an enzyme immunoassay for N-methyl-D-aspartate Receptor subunit NR2 antibodies (anti-NR2), using the synthetic 10-amino-acid sequence peptide DWEYSVWLSN conjugated to human serum albumin, and to explore the association of anti-NR2 in sera and cerebrospinal fluid (CSF) from patients with neuropsychiatric manifestations in systemic lupus erythematosus (NP-SLE).
Method: Paired serum and CSF specimens were obtained from 66 patients with NP-SLE and 12 control patients with non-inflammatory neurological diseases. In addition, sera from patients with rheumatoid arthritis, chronic progressive neuro-Behçet disease, SLE patients without neuropsychiatric manifestations and healthy individuals were also obtained. Of 66 patients with NP-SLE, 43 patients had diffuse psychiatric/neuropsychological syndromes (diffuse NP-SLE), 23 patients had neurologic syndromes (focal NP-SLE), as defined in nomenclature of American College of Rheumatology in 1999.IgG anti-NR2 were measured by enzyme-linked immunosorbent assay.
Result: Serum anti-NR2 were significantly elevated in diffuse NP-SLE patitents compared with those with neuro-Behçet disease, those with SLE without neuropsychiatric manifestations and healthy individuals. However there was no difference between patients with focal NP-SLE and those with diffuse NP-SLE. In addition, CSF anti-NR2 significantly elevated in patients with diffuse NP-SLE compared with patients with focal NP-SLE and those with non-inflammatory neurological diseases.
Conclusion: These results indicate that anti-NR2 in serum and CSF are associated with neuropsychiatric manifestation in SLE. Especially, quantitative determination of anti-NR2 in CSF is a useful tool for diagnosis NP-SLE.
