Magalhães M B, da Silva L M, Voltarelli J C, Donadi E A, Louzada-Junior P
Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Scand J Rheumatol. 2007 Nov-Dec;36(6):442-7. doi: 10.1080/03009740701482768.
To evaluate the association of the presence of lymphocytotoxic, anti-beta2-glycoprotein I (anti-beta2-GPI) and anti-ribosomal P (anti-P) antibodies in patients with systemic lupus erythematosus (SLE), presenting or not neuropsychiatric (NP) manifestations, stratified according to the activity of the disease.
A total of 138 patients with SLE (59 with active NPSLE, 49 with active non-NPSLE, and 30 with inactive disease) and 57 healthy controls were studied. Disease activity was assessed by the SLE Disease Activity Index (SLEDAI). The presence of lymphocytotoxic antibodies was assessed using a complement-dependent lymphocytotoxicity assay. The presence of anti-beta2-GPI and anti-P antibodies was detected by enzyme-linked immunosorbent assay (ELISA).
Lymphocytotoxic antibodies were detected primarily in patients with active disease, that is in 35 out of 59 (59.3%) NPSLE and 23 out of 49 (46.9%) non-NPSLE patients, whereas only four out of 30 (13.3%) inactive SLE patients and none of the healthy controls exhibited the autoantibody. The frequency of lymphocytotoxic antibodies in active SLE patients, considered as a whole or stratified into NPSLE or non-NPSLE, was significantly increased in relation to inactive SLE patients (p<0.001 for each comparison). No significant difference was observed when comparing active NPSLE with non-NPSLE patients. No associations were observed between the presence of anti-beta2-GPI or anti-P antibodies and the activity of SLE or the presence of lymphocytotoxic antibodies.
Lymphocytotoxic antibodies occurred more frequently in patients with active SLE than in patients with inactive disease, irrespective of the presence of NP manifestations, a finding that is similar to classical biomarkers of lupus activity (anti-dsDNA and complement). These results indicate that the assessment of the presence of lymphocytotoxic antibodies may be an additional useful tool for the evaluation of SLE activity.
评估系统性红斑狼疮（SLE）患者中淋巴细胞毒性抗体、抗β2糖蛋白I（抗β2-GPI）抗体及抗核糖体P（抗-P）抗体的存在情况，这些患者伴有或不伴有神经精神（NP）表现，并根据疾病活动度进行分层。
共研究了138例SLE患者（59例活动性神经精神性SLE、49例活动性非神经精神性SLE和30例非活动性疾病患者）以及57名健康对照者。通过SLE疾病活动指数（SLEDAI）评估疾病活动度。使用补体依赖性淋巴细胞毒性试验评估淋巴细胞毒性抗体的存在情况。通过酶联免疫吸附测定（ELISA）检测抗β2-GPI和抗-P抗体的存在情况。
淋巴细胞毒性抗体主要在活动性疾病患者中检测到，即59例神经精神性SLE患者中的35例（59.3%）和49例非神经精神性SLE患者中的23例（46.9%），而30例非活动性SLE患者中只有4例（13.3%）出现该自身抗体，健康对照者均未出现。与非活动性SLE患者相比，活动性SLE患者（整体或分为神经精神性SLE或非神经精神性SLE）中淋巴细胞毒性抗体的频率显著增加（每次比较p<0.001）。比较活动性神经精神性SLE患者与非神经精神性SLE患者时未观察到显著差异。未观察到抗β2-GPI或抗-P抗体的存在与SLE活动度或淋巴细胞毒性抗体的存在之间存在关联。
无论是否存在NP表现，活动性SLE患者中淋巴细胞毒性抗体的出现频率均高于非活动性疾病患者，这一发现与狼疮活动的经典生物标志物（抗双链DNA和补体）相似。这些结果表明，评估淋巴细胞毒性抗体的存在情况可能是评估SLE活动度的另一个有用工具。
