Engel Sinah, Boedecker Simone, Marczynski Paul, Bittner Stefan, Steffen Falk, Weinmann Arndt, Schwarting Andreas, Zipp Frauke, Weinmann-Menke Julia, Luessi Felix
Department of Neurology, Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn), University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Division of Nephrology, Rheumatology and Clinical Immunology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Ther Adv Neurol Disord. 2021 Oct 22;14:17562864211051497. doi: 10.1177/17562864211051497. eCollection 2021.
The aim was to evaluate the diagnostic potential of serum neurofilament light chain (sNfL) measurements in patients with neuropsychiatric systemic lupus erythematosus (NPSLE).
sNfL levels were determined by single molecule array assay in a retrospective cross-sectional cohort of 144 patients with systemic lupus erythematosus (SLE). After log-transformation of sNfL levels, mean sNfL levels were compared between NPSLE patients and SLE patients without neuropsychiatric disease using Student's test. Furthermore, the association of different neuropsychiatric manifestations with sNfL levels was assessed using a one-way analysis of variance (ANOVA) with post hoc analysis. Associations of sNfL with clinical and laboratory parameters were assessed by correlation and multiple linear regression analysis.
NPSLE patients ( = 69) had significantly higher sNfL levels than SLE patients without neuropsychiatric disease manifestations ( = 75; mean difference: 0.13, 95% CI: 0.04-0.22, = 0.006). With regard to the category of NPSLE manifestation, mean sNfL levels were only increased in NPSLE patients with focal central nervous system (CNS) involvement ( = 45; mean difference: 0.16, 95% CI: 0.02-0.30, = 0.019), whereas mean sNfL levels of NPSLE patients with diffuse CNS and peripheral nervous system involvement did not differ from those of SLE patients without neuropsychiatric manifestations. Age and serum creatinine concentrations were identified as relevant contributors to sNfL levels.
sNfL is a promising, easily accessible biomarker for neuropsychiatric involvement in SLE patients and might therefore complement the diagnostic workup of SLE patients with suspected involvement of the nervous system.
目的是评估血清神经丝轻链（sNfL）检测在神经精神性系统性红斑狼疮（NPSLE）患者中的诊断潜力。
通过单分子阵列分析测定144例系统性红斑狼疮（SLE）患者的回顾性横断面队列中的sNfL水平。对sNfL水平进行对数转换后，使用Student's检验比较NPSLE患者和无神经精神疾病的SLE患者的平均sNfL水平。此外，使用单因素方差分析（ANOVA）及事后分析评估不同神经精神表现与sNfL水平的关联。通过相关性和多元线性回归分析评估sNfL与临床和实验室参数的关联。
NPSLE患者（n = 69）的sNfL水平显著高于无神经精神疾病表现的SLE患者（n = 75；平均差异：0.13，95%CI：0.04 - 0.22，P = 0.006）。关于NPSLE表现的类别，仅在有局灶性中枢神经系统（CNS）受累的NPSLE患者中平均sNfL水平升高（n = 45；平均差异：0.16，95%CI：0.02 - 0.30，P = 0.019），而有弥漫性CNS和周围神经系统受累的NPSLE患者的平均sNfL水平与无神经精神表现的SLE患者无差异。年龄和血清肌酐浓度被确定为sNfL水平的相关影响因素。
sNfL是一种有前景且易于获取的生物标志物，可用于SLE患者神经精神受累的诊断，因此可能补充对疑似神经系统受累的SLE患者的诊断检查。
