Department of Therapeutics & Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Li Ka Shing Institute of Health Science (LiHS), The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Int J Rheum Dis. 2023 Aug;26(8):1464-1473. doi: 10.1111/1756-185X.14731. Epub 2023 Jun 27.
To ascertain whether microvascular alterations of eye sign combined with intrathecal concentrations of interleukin-6 (IL-6) can predict the development of neuropsychiatric systemic lupus erythematosus (NPSLE).
Cerebrospinal fluid (CSF) and serum samples of IL-6 were collected and measured at the same time for patients with SLE who were consecutively enrolled. Patients with a diagnosis of NPSLE were identified. Eye sign examinations according to our criteria were performed and scored for all SLE patients. Demographic and clinical parameters were compared between groups to identify potential predictors for NPSLE using multivariable logistic regression analysis. The performance of potential predictors from eye sign along with IL-6 in the CSF was assessed.
A total of 120 patients with SLE were enrolled; 30 with NPSLE and 90 with non-NPSLE. No significant positive correlation was observed between CSF level and serum level of IL-6. CSF IL-6 was significant higher in the NPSLE group than the non-NPSLE (P < 0.001) group. Multivariable logistic analysis revealed that total score, ramified loops, and microangioma of eye sign were predictors for NPSLE after adjusting for SLE Disease Activity Index (SLEDAI) and antiphospholipid antibody (APL). Total score, ramified loops, microangioma of eye sign, and SLEDAI remain significant predictors for NPSLE after adjusting for CSF IL-6. Using receiver operating characteristics curve analysis, the cut-off point of potential predictors was applied in multivariable logistic analysis; APL, total score, ramified loops, and microangioma of eye sign remain significant predictors for NPSLE after adjusting for CSF IL-6.
Specific microvascular alterations of eye sign are predictors for the development of NPSLE in addition to increased IL-6 in the CSF.
确定眼部微血管改变与鞘内白细胞介素-6（IL-6）浓度是否可预测神经精神性系统性红斑狼疮（NPSLE）的发生。
连续招募系统性红斑狼疮（SLE）患者，同时采集脑脊液（CSF）和血清样本以测量 IL-6。确定 NPSLE 患者。对所有 SLE 患者进行了根据我们的标准进行的眼部检查并进行评分。使用多变量逻辑回归分析比较组间的人口统计学和临床参数，以确定 NPSLE 的潜在预测因素。评估来自眼部特征以及 CSF 中 IL-6 的潜在预测因素的性能。
共纳入 120 例 SLE 患者，其中 30 例为 NPSLE，90 例为非 NPSLE。CSF 中 IL-6 水平与血清水平之间未观察到显著正相关。NPSLE 组的 CSF IL-6 明显高于非 NPSLE 组（P < 0.001）。多变量逻辑分析显示，在调整 SLE 疾病活动指数（SLEDAI）和抗磷脂抗体（APL）后，眼部特征的总评分、分支环和微血管瘤是 NPSLE 的预测因素。在调整 CSF IL-6 后，总评分、分支环、微血管瘤和 SLEDAI 仍然是 NPSLE 的重要预测因素。使用受试者工作特征曲线分析，潜在预测因素的临界点应用于多变量逻辑分析；在调整 CSF IL-6 后，APL、总评分、分支环和微血管瘤仍然是 NPSLE 的重要预测因素。
除 CSF 中 IL-6 增加外，眼部特定的微血管改变也是 NPSLE 发生的预测因素。
