Division of Rheumatology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Front Immunol. 2020 Feb 26;11:230. doi: 10.3389/fimmu.2020.00230. eCollection 2020.
Neuropsychiatric symptoms of systemic lupus erythematosus (NP-SLE) affect over one-half of SLE patients, yet underlying mechanisms remain largely unknown. We demonstrate that SLE-prone mice (CReCOM) develop NP-SLE, including behavioral deficits prior to systemic autoimmunity, reduced brain volumes, decreased vascular integrity, and brain-infiltrating leukocytes. NP-SLE microglia exhibit numerical expansion, increased synaptic uptake, and a more metabolically active phenotype. Microglia from multiple SLE-prone models express a "NP-SLE signature" unrelated to type I interferon. Rather, the signature is associated with lipid metabolism, scavenger receptor activity and downregulation of inflammatory and chemotaxis processes, suggesting a more regulatory, anti-inflammatory profile. NP-SLE microglia also express genes associated with disease-associated microglia (DAM), a subset of microglia thought to be instrumental in neurodegenerative diseases. Further, expression of "NP-SLE" and "DAM" signatures correlate with the severity of behavioral deficits in young SLE-prone mice prior to overt systemic disease. Our data are the first to demonstrate the predictive value of our newly identified microglia-specific "NP-SLE" and "DAM" signatures as a surrogate for NP-SLE clinical outcomes and suggests that microglia-intrinsic defects precede contributions from systemic SLE for neuropsychiatric manifestations.
神经精神性系统性红斑狼疮(NP-SLE)的症状影响了超过一半的 SLE 患者,但潜在机制在很大程度上仍然未知。我们证明,SLE 易感小鼠(CReCOM)会发展出 NP-SLE,包括在系统性自身免疫之前出现行为缺陷、脑体积减小、血管完整性降低和脑浸润白细胞。NP-SLE 小胶质细胞表现出数量上的扩张、增加的突触摄取和更具代谢活性的表型。来自多种 SLE 易感模型的小胶质细胞表达一种与 I 型干扰素无关的“NP-SLE 特征”。相反,该特征与脂质代谢、清道夫受体活性以及炎症和趋化过程的下调有关,表明其具有更具调节性、抗炎的特征。NP-SLE 小胶质细胞还表达与疾病相关小胶质细胞(DAM)相关的基因,DAM 是被认为在神经退行性疾病中起重要作用的小胶质细胞亚群。此外,“NP-SLE”和“DAM”特征的表达与年轻 SLE 易感小鼠在出现明显系统性疾病之前行为缺陷的严重程度相关。我们的数据首次证明了我们新发现的小胶质细胞特异性“NP-SLE”和“DAM”特征作为 NP-SLE 临床结果的替代指标的预测价值,并表明小胶质细胞内在缺陷先于系统性 SLE 对神经精神表现的贡献。