Isshi K, Hirohata S
Teikyo University School of Medicine, Tokyo, Japan.
Arthritis Rheum. 1998 Oct;41(10):1819-27. doi: 10.1002/1529-0131(199810)41:10<1819::AID-ART14>3.0.CO;2-Y.
To compare the role of antibodies against the ribosomal P protein (anti-P) with that of antibodies against neuronal cells (anti-N) in the pathogenesis of central nervous system (CNS) involvement in systemic lupus erythematosus (SLE).
Sera from 87 SLE patients (27 with non-CNS SLE, 34 with lupus psychosis, and 26 with nonpsychotic CNS lupus) and from 20 control patients with neurologic manifestations without SLE and cerebrospinal fluid (CSF) from 41 patients with CNS lupus and from the 20 control patients were assayed for IgG anti-P and anti-N by an enzyme-linked immunosorbent assay (ELISA) using ribosomal P synthetic peptides and by a cell ELISA using paraformaldehyde-fixed SK-N-MC neuroblastoma cell lines, respectively.
Serum anti-P levels were significantly elevated in patients with lupus psychosis compared with those with non-CNS SLE or those with nonpsychotic CNS lupus, whereas there were no significant differences in serum anti-N levels among these 3 groups. In contrast, CSF anti-N levels were significantly elevated in patients with lupus psychosis compared with those with nonpsychotic CNS lupus and compared with non-SLE controls, whereas CSF anti-P were not detected in most of the patients.
The results indicate that anti-P in the systemic circulation and anti-N in the CSF are involved in the development of lupus psychosis.
比较抗核糖体P蛋白抗体（抗-P）与抗神经细胞抗体（抗-N）在系统性红斑狼疮（SLE）中枢神经系统（CNS）受累发病机制中的作用。
采用酶联免疫吸附测定（ELISA）法，分别以核糖体P合成肽检测87例SLE患者（27例非CNS-SLE患者、34例狼疮精神病患者和26例非精神病性CNS狼疮患者）以及20例有神经系统表现但无SLE的对照患者血清中的IgG抗-P和抗-N；采用细胞ELISA法，以多聚甲醛固定的SK-N-MC神经母细胞瘤细胞系检测41例CNS狼疮患者及20例对照患者的脑脊液（CSF）中的抗-P和抗-N。
与非CNS-SLE患者或非精神病性CNS狼疮患者相比，狼疮精神病患者血清抗-P水平显著升高，而这3组患者的血清抗-N水平无显著差异。相反，与非精神病性CNS狼疮患者及非SLE对照相比，狼疮精神病患者脑脊液抗-N水平显著升高，而大多数患者脑脊液中未检测到抗-P。
结果表明，全身循环中的抗-P及脑脊液中的抗-N参与了狼疮精神病的发生。
