Objective. Autoantibodies against ribosomal P proteins are linked to the neuropsychiatric manifestations of systemic lupus erythematosus (SLE). The present study was undertaken to assess how the specific brain-binding autoantibody anti-ribosomal P can induce a depression-type psychiatric disorder in mice.Methods. Mice were injected intracerebroventricularly with affinity-purified human anti-ribosomal P antibodies or IgG as control. Pharmacologic and immunologic treatments included the antidepressant drug fluoxetine, the antipsychotic drug haloperidol, and antiidiotypic antibodies. Behavior was assessed by the forced swimming test, motor deficits by rotarod, grip strength, and staircase tests, and cognitive deficits by T-maze alternation and passive avoidance tests.Results. Anti-ribosomal P antibodies induced depression-like behavior in the mice (mean ؎ SEM 147.3 ؎ 19.2 seconds of immobility versus 75.2 ؎ 12.1 seconds of immobility in IgG-injected control mice; P < 0.005). The anti-ribosomal P antibody-induced depression-like behavior was partially blocked by a specific antiidiotypic antibody and significantly blocked by long-term treatment with fluoxetine, but not by shortor long-term treatment with haloperidol. The depressive behavior was not associated with any motor or cognitive deficits. Anti-ribosomal P antibodies specifically stained neurons in the hippocampus, cingulate cortex, and the primary olfactory piriform cortex, compatible with the previously described binding to the membranebound P0 ribosomal protein.Conclusion. This is the first report of an experimental depression induced by a specific autoantibody. The results implicate olfactory and limbic areas in the pathogenesis of depression in general, and in central nervous system dysfunction in SLE in particular.The anti-ribosomal P antibodies are members of a polyspecific population of autoantibodies that target 3 highly conserved ribosomal phosphoproteins (1). These proteins comprise P0, P1, and P2 molecules that correspond to sizes of 38 kd, 19 kd, and 17 kd, respectively. P proteins are acidic phosphoproteins associated mainly with the 60S ribosomal subunit in eukaryotic cells. The existence of ribosome-free P proteins in the cytoplasm and the presence of P0 on the surface of the cell membrane have also been reported (2-4). The antiribosomal P antibody is specific to systemic lupus erythematosus (SLE) (1) and is detected predominantly in patients during the active phases of the disease (5,6). These autoantibodies in SLE recognize an epitope that is confined within the 22-carboxy-terminal amino acids, and this pattern is identical in P0, P1, and P2 proteins (7). According to observations in the literature, there is some variability regarding the prevalence of antiribosomal P in SLE patients, ranging from 6% to 36% (5,(8)(9)(10). The prevalence of anti-ribosomal P is higher in Asians than in blacks or whites (9), and genetic factors may account for the wide range of anti-ribosomal P frequencies among SLE patients (11).A link between anti-ribosomal P ...

Prior application of synthetic mesh during abdominal wall surgery creates difficulties during subsequent urological procedures and may dictate change in operative planning. Nevertheless, the surgery is feasible and should not be ruled out.

In the months before the Second Gulf War, the threat of biological and chemical warfare led many Israelis to experience significant stress and mood changes. In this study, we investigated whether this threat affected the subjective mood and behavior of inpatients with schizophrenia and compared the results with effects noted in their clinical staff. Subjects were evaluated at two points in time-2 months before the war and on day 1 of the war-with a specially designed questionnaire and with the Spielberger Scale for Trait Anxiety. Although the responses of the two groups did not differ radically before the war, on the first day of war, significant differences were noted, with patients demonstrating increases in anxiety and level of concern. Both groups reported similar effects on their mood. Patients were more concerned about the potential for the outbreak of World War III, whereas staff were more concerned about economic effects. Female subjects in both groups demonstrated greater anxiety and mood changes after the outbreak of war compared with before the war. Effects observed on the patients may be related to the decreased coping threshold resulting from their illness, which renders psychotic patients more vulnerable to any acute stressor; however, effects on the staff members should not be ignored.