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抗N-甲基-D-天冬氨酸受体和抗核糖体P自身抗体导致系统性红斑狼疮的认知功能障碍。

Anti-N-methyl-D-aspartate receptor and anti-ribosomal-P autoantibodies contribute to cognitive dysfunction in systemic lupus erythematosus.

作者信息

Massardo L, Bravo-Zehnder M, Calderón J, Flores P, Padilla O, Aguirre J M, Scoriels L, González A

机构信息

Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina

Departamento de Inmunología Clínica y Reumatología, Facultad de Medicina Centro de Envejecimiento y Regeneración, Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas.

出版信息

Lupus. 2015 May;24(6):558-68. doi: 10.1177/0961203314555538. Epub 2014 Oct 15.

Abstract

OBJECTIVE

Autoantibodies against N-methyl-D-aspartate receptor (anti-NMDAR) and ribosomal-P (anti-P) antigens are potential pathogenic factors in the frequently observed diffuse brain dysfunctions in patients with systemic lupus erythematosus (SLE). Although studies have been conducted in this area, the role of anti-NMDAR antibodies in SLE cognitive dysfunction remains elusive. Moreover, the specific contribution of anti-P antibodies has not been reported yet. The present study attempts to clarify the contribution of anti-NMDAR and anti-P antibodies to cognitive dysfunction in SLE.

METHODS

The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess a wide range of cognitive function areas in 133 Chilean women with SLE. ANCOVA models included autoantibodies, patient and disease features.

RESULTS

Cognitive deficit was found in 20%. Higher SLEDAI-2K scores were associated with impairment in spatial memory and learning abilities, whereas both anti-NMDAR and anti-P antibodies contributed to deficits in attention and spatial planning abilities, which reflect fronto-parietal cortex dysfunctions.

CONCLUSIONS

These results reveal an association of active disease together with specific circulating autoantibodies, such as anti-NMDAR and anti-P, with cognitive dysfunction in SLE patients.

摘要

目的

抗 N-甲基-D-天冬氨酸受体自身抗体(抗 NMDAR)和核糖体-P 自身抗体(抗-P)是系统性红斑狼疮(SLE)患者中常见的弥漫性脑功能障碍的潜在致病因素。尽管该领域已开展了相关研究,但抗 NMDAR 抗体在 SLE 认知功能障碍中的作用仍不明确。此外,抗-P 抗体的具体作用尚未见报道。本研究旨在阐明抗 NMDAR 和抗-P 抗体对 SLE 认知功能障碍的影响。

方法

采用剑桥神经心理测试自动成套系统(CANTAB)对 133 名智利 SLE 女性患者的多种认知功能领域进行评估。协方差分析模型纳入了自身抗体、患者及疾病特征。

结果

20%的患者存在认知缺陷。较高的 SLEDAI-2K 评分与空间记忆和学习能力受损相关,而抗 NMDAR 和抗-P 抗体均导致注意力和空间规划能力缺陷,这反映了额顶叶皮质功能障碍。

结论

这些结果揭示了活动性疾病以及特定的循环自身抗体,如抗 NMDAR 和抗-P,与 SLE 患者认知功能障碍之间的关联。

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