BACKGROUND: The neurofilament light chain (NfL) in cerebrospinal fluid (CSF) and serum as a marker of neuronal damage may be a potential biomarker of neuropsychiatric involvement in SLE (NPSLE). METHODS: 80 patients with SLE were included.We obtained paired serum and CSF samples from 48 patients (NPSLE n=32, non-NPSLE n=16) and 31 controls. The serum and CSF levels of NfL were determined using ELISA. RESULTS: Patients with NPSLE demonstrated significantly higher levels of serum NfL compared with the non-NPSLE group (mean 31.68±36.63 pg/mL vs mean 16.75±12.48 pg/mL, respectively, p<0.05) and with controls (mean 10.74±4.36 pg/mL, p<0.01). Notably, CSF NfL concentrations in patients with NPSLE showed an upward trend (mean 1600±2852 pg/mL) in contrast to non-NPSLE patients (mean 393.4±191.9 pg/mL) and controls (mean 509.7±358.5 pg/mL). Furthermore, a positive correlation was observed between serum and CSF NfL levels in patients with NPSLE (R=0.8686, p<0.01). Elevated serum triacylglycerol concentrations, C reactive protein and organ damage were linked to increased serum (p=0.002; p<0.001; p=0.036) and CSF (p=0.008; p=0.007; p<0.001) NfL concentrations. In addition, we established a significant correlation between intrathecal NfL concentrations and interleukin-6 levels in the CSF of patients with NPSLE (R=0.5118, p<0.05). CONCLUSION: The serum NfL levels may be a readily available marker of neuropsychiatric involvement in SLE.

• MeSH
• Biomarkers * blood   cerebrospinal fluid   MeSH
• Adult MeSH
• Enzyme-Linked Immunosorbent Assay MeSH
• Interleukin-6 blood   cerebrospinal fluid   MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Neurofilament Proteins * blood   cerebrospinal fluid   MeSH
• Cross-Sectional Studies MeSH
• Case-Control Studies MeSH
• Lupus Vasculitis, Central Nervous System * blood   cerebrospinal fluid   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Antibodies, Antiphospholipid pharmacology   MeSH
• Antiphospholipid Syndrome * pathology   MeSH
• Anticoagulants pharmacology   therapeutic use   MeSH
• Antimalarials pharmacology   therapeutic use   MeSH
• Chorea * diagnosis   drug therapy   pathology   MeSH
• Diagnostic Imaging methods   MeSH
• Diagnosis, Differential MeSH
• Glucocorticoids pharmacology   therapeutic use   MeSH
• Platelet Aggregation Inhibitors pharmacology   therapeutic use   MeSH
• Immunoglobulins, Intravenous therapeutic use   MeSH
• Humans MeSH
• Plasmapheresis methods   MeSH
• Risk Factors MeSH
• Lupus Erythematosus, Systemic diagnosis   drug therapy   pathology   MeSH
• Check Tag
• Humans MeSH

• Publication type
• Meeting Abstract MeSH

The aim of this study was to determine the role of the tumor necrosis factor like weak inducer of apoptosis (TWEAK) as a serum biomarker of neuropsychiatric involvement in systemic lupus erythematosus (NPSLE). Levels of TWEAK levels were measured in sera of 92 patients with systemic lupus erythematosus (SLE), including 28 patients with neuropsychiatric lupus, and in 59 healthy controls using ELISA. All SLE patients underwent rheumatological, neurological and psychiatric assessment. We found no significant differences in TWEAK levels, between SLE patients and the healthy controls (p=0.2411). Similarly, no difference was observed between subgroup of NPSLE and healthy controls (p=0.7658). The mean SLE disease activity (SLEDAI) was 13.25. No correlations between TWEAK levels with disease activity (SLEDAI, r=0.2113, p=0.2805) or the most common NPSLE manifestations such as headache (r=0.2079), seizures (r=0.1101), cerebrovascular disease (r= 0.2347), cognitive dysfunction (r=0.1597) and anxiety (r=0.1397) were observed. Our data do not support the use of serum TWEAK as a discriminating biomarker for NPSLE. The role of the TWEAK in NPSLE remains to be investigated.

• MeSH
• Biomarkers blood   MeSH
• Cytokine TWEAK blood   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Anxiety blood   diagnosis   psychology   MeSH
• Lupus Vasculitis, Central Nervous System blood   diagnosis   psychology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Antiphospholipid Syndrome drug therapy   MeSH
• Cognition Disorders diagnosis   MeSH
• Drug Therapy, Combination MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Cerebrospinal Fluid cytology   MeSH
• Neurobehavioral Manifestations MeSH
• Progressive Patient Care MeSH
• Risk Factors MeSH
• Lupus Erythematosus, Systemic diagnostic imaging   drug therapy   pathology   MeSH
• Lupus Vasculitis, Central Nervous System genetics   immunology   classification   pathology   MeSH
• Check Tag
• Humans MeSH

• Publication type
• Meeting Abstract MeSH

• Publication type
• Meeting Abstract MeSH

Neuropsychiatrické postižení u systémového lupus erythematodes (NPSLE) představuje závažnou komplikaci této choroby, která významně zhoršuje kvalitu života nemocného. Jde o jeden z nejkomplexnějších projevů systémového lupusu, který může postihnout centrální, periferní i autonomní nervový systém. Přesná patofyziologie tohoto onemocnění není dosud známa a specifický biomarker sloužící k jejímu odhalení také ne. Vyšetření mozkomíšního moku je v posledních letech věnována větší pozornost, zejména při diagnostickém algoritmu NPSLE. Mimo standardní cytologické, biochemické a imunologické vyšetření nabízí též možnost detekce autoprotilátek, zánětlivých mediátorů a poruchy hematoencefalické bariéry. Cílem této práce je shrnout nejčastější likvorové nálezy u pacientů s neuropsychiatrickým postižením u systémového lupus erythematodes. Nejčastějším typem celulární odpovědi v likvoru NPSLE je mírná pleocytóza s převahou lymfocytů, u transverzální myelitidy pak neutrofilní granulocytóza. V biochemickém vyšetření bývá v likvoru až v polovině případů zvýšena celková bílkovina, stejně tak jako elevace Q albuminového kvocientu, který ukazuje na poškození hematoencefalické bariéry. Častým nálezem také bývá zvýšení IgG indexu a detekce intratékální oligoklonální syntézy IgG. Z prozánětlivých cytosinů jsou v likvoru ve většině případů NPSLE přítomny IL-6 a IL-8. Z autoprotilátek vykazují asociaci s NPSLE anti-RP, anti-N, anti-U1RNP a anti-Sm protilátky. Klíčová slova: neuropsychiatrický systémový lupus erythematodes, mozkomíšní mok

Neuropsychiatric systemic lupus erythematosus (NPSLE) is a serious complication of this disease which significantly degrades the quality of life of the patient. This is one of the most complex manifestations of systemic lupus, which can affect the central, peripheral and autonomic nervous system. The exact pathophysiology of this disease is not known yet, neither is a specific biomarker for its detection. The neurological examination of cerebrospinal fluid has received more attention in recent years, especially in the NPSLE diagnostic algorithm. Besides standard cytological, biochemical and immunological examinations, it also offers the possibility of detection of autoantibodies, inflammatory mediators and blood-brain barrier disorders. The aim of this work is to summarize the most frequent findings in patients with neuropsychiatric involvement in systemic lupus erythematosus. The most common type of cellular response in NPSLE is mild pleocytosis with a majority of lymphocytes, and neutrophilic granulocytosis in transverse myelitis. In the biochemical examination of the cerebrospinal fluid, in up to half of the cases the total protein and the albumin quotient were increased, indicating damage to the blood-brain barrier. A frequent finding is also an increase in the IgG index and detection of intrathecal oligoclonal IgG synthesis. Of the pro-inflammatory cytokines, IL-6 and IL-8 are present in most cases of NPSLE. Proteins that are associated with NPSLE include anti-RP, anti-N, anti-U1RNP and anti-Sm antibodies. Key words: neuropsychiatric systemic lupus erythematosus, cerebrospinal fluid

• MeSH
• Autoantibodies analysis   MeSH
• Diagnosis, Differential MeSH
• Blood-Brain Barrier physiology   MeSH
• Humans MeSH
• Meta-Analysis as Topic MeSH
• Cerebrospinal Fluid * cytology   chemistry   MeSH
• Lupus Vasculitis, Central Nervous System * diagnosis   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• Publication type
• Meeting Abstract MeSH

Lupus erythematodes (SLE) je chronické systémové autoimunitní onemocnění se širokou škálou manifestací. Může postihnout prakticky všechny orgánové systémy, a proto je jeho klinický obraz velice variabilní. K jeho diagnostice se užívají klasifikační kritéria SLICC (The Systemic Lupus International Collaborating Clinic), uplatňující kromě klinického obrazu laboratorní a imunologické výsledky a také nálezy dalších pomocných vyšetření. Sledování a léčba pacientů jsou založeny na mezioborové spolupráci specialistů s koordinací revmatologa. Cílem tohoto článku je shrnout nejčastější manifestace a diagnostické metody u tohoto onemocnění.

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease with a wide range of manifestations. It can affect almost all organ systems, so the clinical picture of this disease is very variable. To determine the diagnosis we use the SLICC classification criteria (The Systemic Lupus International Collaborating Clinic), which are based on the clinical picture, laboratory, and immunological results and other additional methods. The monitoring and treatment of patients are based on the interdisciplinary cooperation of specialists with the coordination of a rheumatologist. The aim of this article is to summarize the most common manifestations and diagnostic methods associated with this disease.

• MeSH
• Antiphospholipid Syndrome etiology   mortality   MeSH
• Antibodies, Antinuclear blood   MeSH
• Antirheumatic Agents administration & dosage   pharmacology   MeSH
• Diagnosis, Differential MeSH
• Protein-Losing Enteropathies diagnostic imaging   etiology   drug therapy   MeSH
• Glucocorticoids administration & dosage   pharmacology   MeSH
• Immunosuppressive Agents administration & dosage   pharmacology   MeSH
• Induction Chemotherapy methods   MeSH
• Skin Manifestations MeSH
• Humans MeSH
• Lupus Nephritis classification   mortality   pathology   MeSH
• Pericarditis diagnostic imaging   epidemiology   etiology   MeSH
• Pleurisy diagnostic imaging   etiology   MeSH
• Lupus Erythematosus, Systemic * diagnosis   classification   pathology   MeSH
• Lupus Vasculitis, Central Nervous System diagnostic imaging   etiology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH