The Study of Anticardiolipin Antibodies and Interleukin-6 in Cerebrospinal Fluid and Blood of Chinese Patients with Systemic Lupus Erythematosus and Central Nervous System Involvement

Yeh, Tsann-Sheng; Wang, Chrong‐Reen; Jeng, G.; Lee, Gwon-Loon; Chen, Mao-Yuan; Wang, Gong-Ren; Lin, Kuei-Tang; Chuang, Che-Yen; Chen, Chien‐Yen

doi:10.3109/08916939409007993

Cited by 24 publications

(16 citation statements)

References 17 publications

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“…Possible mechanisms include a direct effect of antibodies causing seizures, the trapping of immune complexes within vessels resulting in seizures , and antiphospholipid antibodies causing microvascular lesions. The direct effect of antibodies in provoking epilepsy is supported by studies showing that antibrain antibodies can directly cause seizures3 25; that serum from patients with systemic lupus erythematosus with epilepsy and anticardiolipin antibodies can inhibit Cl − currents through the GABA receptor complex26; and that the presence of anticardiolipin antibodies in the CSF is longitudinally associated with clinical symptoms 27. The finding that antiphospholipid antibodies react directly with CNS tissue28 does not rule out secondary damage as a mechanism for seizures.…”

Section: Epilepsy Associated With Autoimmune Diseasesmentioning

confidence: 99%

Epilepsy: an autoimmune disease?

Palace

2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Section: Epilepsy Associated With Autoimmune Diseasesmentioning

confidence: 99%

Epilepsy: an autoimmune disease?

Palace

2000

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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“…Elevated concentrations of IgG in the cerebrospinal fluid (CSF), of the IgG–albumin ratio and of the IgG index, and the presence of oligoclonal bands have all been described with varying frequencies in patients with NPSLE [11-13]. A few studies have demonstrated elevated IL-6 levels in the CSF from patients with CNS lupus [14-18]. Some other reports have described increased levels of IL-1 [14], of IL-8 [16] and of interferon gamma [19] in CSF from patients with CNS lupus.…”

Section: Introductionmentioning

confidence: 99%

Decreased levels of soluble amyloid β-protein precursor and β-amyloid protein in cerebrospinal fluid of patients with systemic lupus erythematosus

et al. 2004

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Central nervous system (CNS) involvement has been reported to occur in 14-75% of all systemic lupus erythematosus (SLE) patients [1][2][3]. The large differences regarding the frequency depend on the diagnostic criteria applied. CNS lupus can occur at any time during the course of SLE and its symptoms are extremely diverse. The features of this condition may include seizures, stroke, depression, psychoses and disordered mentation. Dementia, a common state in the population in general, is occasionally also reported in SLE patients [4]. Neuropsychiatric involvement in SLE (NPSLE) has been shown to predict a high frequency of flares and is considered a major cause of longstanding functional impairment as well as a cause of mortality [5]. CNS lupus in recent decades has been treated with cytotoxic drugs that improve the disease outcome [6,7]. However, acquisition of valuable treatment remedies increases the need for early recognition of CNS AD = Alzheimer disease; Aβ42 = β-amyloid protein; APP = amyloid precursor protein; CNS = central nervous system; CSF = cerebrospinal fluid; ELISA = enzyme-linked immunosorbent assay; IL = interleukin; MRI = magnetic resonance imaging; NPSLE = neuropsychiatric systemic lupus erythematosus; SLE = systemic lupus erythematosus; TGF-β = transforming growth factor beta. Online ISSN 1478-6362). This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. AbstractSymptoms originating from the central nervous system (CNS) frequently occur in patients with systemic lupus erythematosus (SLE). These symptoms are extremely diverse, including a state of dementia. The aim of this study was to examine the cerebrospinal fluid (CSF) content of soluble molecules indicating axonal degeneration and amyloidogenesis.One hundred and fourteen patients with SLE and age-matched controls were evaluated clinically, with magnetic resonance imaging of the brain and CSF analyses. Levels of tau, amyloid precursor protein (APP), β-amyloid protein (Aβ42), and transforming growth factor beta (TGF-β) were all determined using sandwich ELISAs.APP and Aβ42 levels were significantly decreased in SLE patients irrespective of their CNS involvement, as compared with healthy controls. Patients with neuropsychiatric SLE who underwent a second lumbar puncture following successful cyclophosphamide treatment showed further decreases of Aβ42. CSF-tau levels were significantly increased in SLE patients showing magnetic resonance imaging-verified brain pathology as compared with SLE patients without such engagement. Importantly, tau levels displayed significant correlation to Aβ42 levels in the CSF. Finally, TGF-β levels were significantly increased in patients with neuropsychiatric SLE as compared with those without.Low intrathecal levels of Aβ42 found in SLE patients seem to be a direct consequence of a diminished production of APP, probably mediated by heavy anti-inflammatory/immunosuppre...

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“…A stronger association between aPL and neurological disorders might be easier to establish if aPL are sought and detected in the cerebral spinal fluid (CSF) of patients experiencing neurologic symptoms. Historically, scarce reports of aPL in CSF are limited mostly to IgG and IgM anticardiolipin (aCL) detection (Marchiorri, 1990;Lolli et al, 1991;Wang et al, 1992;Gallo et al, 1994;Yeh et al, 1994;Martinez-Cordero, 1997;Jedryka-Goral et al, 2000;Lai and Lan, 2000;Baraczka et al, 2002). Rarely are IgA aCL sought (Wang et al, 1992).…”

mentioning

confidence: 99%

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

Sokol

Wagenknecht

McIntyre

2004

Journal of Immunology Research

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Antiphospholipid antibodies (aPL) have been found in the blood of patients with systemic and neurological disease. The rare reports of aPL in cerebral spinal fluid (CSF) have been limited mostly to IgG and IgM anticardiolipin (aCL). Our published finding of IgA aPE in the CSF of a young stroke victim prompted us to establish "normal" CSF aPL values for a panel of aPL, which included aCL, antiphosphatidylserine (aPS), antiphosphatidylethanolamine (aPE) and antiphosphatidylcholine (aPC). CSF samples were tested by ELISA for IgG, IgM and IgA aPL. In addition, the CSF samples were tested for activity in the presence and absence of phospholipid (PL) binding plasma-proteins. A total of 24 data points were obtained for each CSF sample. We tested 59 CSF samples obtained from 59 patients who were undergoing evaluation for systemic or neurologic diseases. All CSF samples had normal protein, glucose and cell counts. Ten of the 59 CSF samples (17%) had elevated aPL optical density (OD) values an order of magnitude higher than the other 49 CSF samples for one or more aPL specificity and/or isotype. One CSF sample had both PL-binding protein dependent and independent IgG aPE activity. Another CSF sample showed both IgG aPE and aPC reactivity. The remaining eight CSF samples showed single aPL findings; IgG aPE (5), IgG aPC (1), IgG aCL (1) and IgM aPC (1). Seven of 10 patients with elevated CSF values were females. As expected, most "normal" aPL OD values were substantially lower in CSF than those we have reported in blood samples from volunteer blood donors. Jacobson et al., 1999). The associations of aPL with neurologic conditions other than thromboocclusive events have been considered "weak" and attributable to an "epiphenomenon" rather than to pathophysiologic mechanisms (Brey, 2000). A stronger association between aPL and neurological disorders might be easier to establish if aPL are sought and detected in the cerebral spinal fluid (CSF) of patients experiencing neurologic symptoms. Historically, scarce reports of aPL in CSF are limited mostly to IgG and IgM anticardiolipin (aCL) detection (Marchiorri, 1990;Lolli et al., 1991;Wang et al., 1992;Gallo et al., 1994;Yeh et al., 1994;Martinez-Cordero, 1997;Jedryka-Goral et al., 2000;Lai and Lan, 2000;Baraczka et al., 2002). Rarely are IgA aCL sought (Wang et al., 1992). To our knowledge only one report included testing for IgG and IgM antiphosphatidylserine (aPS) and antiphosphatidylethanolamine (aPE) in CSF; the results were negative (Gallo et al., 1994). Our finding of IgA aPE in the CSF of a young stroke victim (Sokol et al., 2000), together with our intent to continue testing additional CSF samples, prompted us to undertake and establish "normal" aPL values for CSF. Our findings form the basis of this report. PATIENTS AND METHODSBecause of the potential risks associated with spinal taps to healthy individuals we were unable to obtain CSF samples from random donors. We opted to perform a retrospective analysis using residual CSF that was collected for diagnostic purposes a...

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The Study of Anticardiolipin Antibodies and Interleukin-6 in Cerebrospinal Fluid and Blood of Chinese Patients with Systemic Lupus Erythematosus and Central Nervous System Involvement

Cited by 24 publications

References 17 publications

Epilepsy: an autoimmune disease?

Epilepsy: an autoimmune disease?

Decreased levels of soluble amyloid β-protein precursor and β-amyloid protein in cerebrospinal fluid of patients with systemic lupus erythematosus

Testing for Antiphospholipid Antibody (aPL) Specificities in Retrospective “Normal” Cerebral Spinal Fluid (CSF)

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