Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA.
Rheum Dis Clin North Am. 2010 Feb;36(1):187-201, x-xi. doi: 10.1016/j.rdc.2009.12.007.
The recent appreciation that a subset of anti-DNA antibodies cross-reacts with the N-methyl-d-aspartate receptor encourages a renewed examination of antibrain reactivity in systemic lupus erythematosus (SLE) autoantibodies. Moreover, investigations of their autospecificity present a paradigm for studies of antibrain reactivity and show that (1) serum antibodies access brain tissue only after a compromise of blood-brain barrier integrity, (2) the same antibodies have differential effects on brain function depending on the region of brain exposed to the antibodies, and (3) insults to the blood-brain barrier are regional rather than diffuse. These studies suggest that an anatomic classification scheme for neuropsychiatric SLE may facilitate research on etiopathogenesis and the design of clinical trials.
最近的认识是,一组抗 DNA 抗体与 N-甲基-D-天冬氨酸受体发生交叉反应,这促使人们重新审视系统性红斑狼疮 (SLE) 自身抗体中的脑反应性。此外,对它们的自身特异性的研究为脑反应性研究提供了范例,并表明:(1)只有在血脑屏障完整性受到损害后,血清抗体才能进入脑组织;(2)相同的抗体对不同脑区的脑功能有不同的影响;(3)血脑屏障的损伤是区域性的而不是弥漫性的。这些研究表明,神经精神性 SLE 的解剖分类方案可能有助于研究发病机制和临床试验的设计。