Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China.
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
J Immunol Res. 2019 Mar 31;2019:7430780. doi: 10.1155/2019/7430780. eCollection 2019.
Systemic lupus erythematosus (SLE) is an immune disease characterized by multiorgan involvement. Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the most devastating complications of SLE, which lacks efficient diagnostic biomarkers. The recent studies on the anti-GAPDH autoantibodies suggested its potential pathogenic roles in NPSLE. However, the clinical relevance of the anti-GAPDH autoantibodies in patients with SLE is still elusive. In this study, we sought to determine the serum levels of the anti-GAPDH autoantibodies in patients with SLE to investigate the clinical significance of the anti-GAPDH autoantibodies in SLE.
Concentrations of the glyceraldehyde 3-phosphate dehydrogenase autoantibodies (anti-GAPDH autoantibodies) in the serum of 130 SLE patients and 55 healthy individuals were determined by enzyme-linked immunosorbent assay (ELISA). Among the 130 SLE patients, 95 were SLE patients without neuropsychiatric symptoms and 35 had NPSLE. White blood cell (WBC) count, hemoglobin (HB), platelet count (PLT), IgG, IgA, IgM, anti-dsDNA, C3, C4, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF, anti-cardiolipin (Acl), ANA, AnuA, anti-SSA, anti-SSB, 2-GPI, urinalysis, and 24 h urine protein were measured by standard laboratory techniques. Systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index scores were evaluated accordingly.
The serum levels of the anti-GAPDH autoantibodies were significantly elevated in the SLE patients, especially in the patients with NPSLE ( = 0.0011). Elevated serum anti-GAPDH was correlated with increased SLEDAI-2K ( = 0.017), ESR, IgG, and IgM and associated with increased intracranial pressure and incidence of cerebrovascular lesions, but it was protective for seizure disorder incidence.
Serum anti-GAPDH autoantibody was increased in both groups of SLE patients with or without neuropsychiatric symptoms and associated with disease severity. It could become an indicator of tissue damages in the brain for the future clinical practice.
系统性红斑狼疮（SLE）是一种以多器官受累为特征的自身免疫性疾病。神经精神性系统性红斑狼疮（NPSLE）是 SLE 最具破坏性的并发症之一，目前缺乏有效的诊断生物标志物。最近关于抗 GAPDH 自身抗体的研究表明其在 NPSLE 中具有潜在的致病作用。然而，SLE 患者抗 GAPDH 自身抗体的临床相关性仍不清楚。本研究旨在检测 SLE 患者血清中抗 GAPDH 自身抗体的水平，以探讨抗 GAPDH 自身抗体在 SLE 中的临床意义。
采用酶联免疫吸附试验（ELISA）检测 130 例 SLE 患者和 55 名健康对照者血清中甘油醛 3-磷酸脱氢酶自身抗体（抗 GAPDH 自身抗体）的浓度。在 130 例 SLE 患者中，95 例为无神经精神症状的 SLE 患者，35 例为 NPSLE 患者。采用标准实验室技术检测白细胞计数（WBC）、血红蛋白（HB）、血小板计数（PLT）、IgG、IgA、IgM、抗双链 DNA（抗 dsDNA）、补体 3（C3）、补体 4（C4）、红细胞沉降率（ESR）、C 反应蛋白（CRP）、类风湿因子（RF）、抗心磷脂抗体（Acl）、抗核抗体（ANA）、抗核糖体 P 蛋白（AnuA）、抗 SSA、抗 SSB、2-糖蛋白 I（2-GPI）、尿蛋白定性和 24 小时尿蛋白定量。根据系统性红斑狼疮疾病活动指数 2000（SLEDAI-2K）和系统性红斑狼疮国际合作临床组/美国风湿病学会（SLICC/ACR）损害指数进行相应评估。
SLE 患者血清抗 GAPDH 自身抗体水平明显升高，尤其是 NPSLE 患者（ = 0.0011）。升高的血清抗 GAPDH 与 SLEDAI-2K 升高（ = 0.017）、ESR、IgG 和 IgM 相关，与颅内压升高和脑血管病变发生率增加相关，但与癫痫发生率降低相关。
SLE 患者无论有无神经精神症状，血清抗 GAPDH 自身抗体均升高，与疾病严重程度相关。它可能成为未来临床实践中脑内组织损伤的指标。
