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Cell-ELISA detection of antineuronal antibodies in central nervous system involvement in systemic lupus erythematosus
  1. Xuan Zhang*,
  2. Huijun Shu*,
  3. Fengchun Zhang,
  4. Xinping Tian,
  5. Yi Dong
  1. Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
  1. Correspondence to:
    Professor Y Dong
    Department of Rheumatology and Immunology, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China; zxpumch2003{at}yahoo.com.cn

Abstract

Objective: To develop a cell-ELISA method to detect antineuronal antibodies (anti-Ns) and evaluate the diagnostic value of anti-Ns in central nervous system involvement in systemic lupus erythematosus (CNS-SLE).

Method: Anti-N was assessed in both serum and cerebrospinal fluid (CSF) samples from 38 patients with CNS-SLE, 29 with SLE without CNS involvement (non-CNS-SLE), 36 with other rheumatic diseases and 59 with non-rheumatic diseases with the CNS manifestations using a cell-ELISA method with 1% paraformaldehyde-fixed SK-N-MC neuroblastoma cells as substrate. Serum samples from 37 healthy donors were also included in this study. Patients with CNS-SLE who were anti-N positive in CSF were studied serially for CSF anti-N levels at times of treatment-associated improvement in CNS symptoms.

Results: Serum anti-N levels were significantly increased in patients with SLE compared with other groups, with a sensitivity of 61.2% (41/67) and a specificity of 91.8% (p<0.001). CSF anti-N levels were significantly increased in patients with CNS-SLE, with a sensitivity of 47.4% (18/38) and a specificity of 89.7%, whereas only 10.3% (3/29) of patients with non-CNS-SLE had increased anti-N in CSF (p<0.001). CSF anti-N levels decreased significantly after effective treatment of CNS-SLE (p<0.05).

Conclusion: Serum anti-N is relatively specific to SLE. CSF anti-N is a sensitive and relatively specific antibody in diagnosing CNS-SLE and correlates with CNS-SLE activity.

  • ANA, antinuclear antibody
  • Anti-N, antineuronal antibody
  • CNS, central nervous system
  • CSF, cerebrospinal fluid
  • ODr, relative concentration of antineuronal antibodies
  • SLE, systemic lupus erythematosus

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Footnotes

  • * XZ and HS contributed equally to this work.

  • Published Online First 11 August 2006

  • Funding: This study was supported by the National Natural Sciences Foundation of China (30400410), New Century Excellent Talent, Ministry of Education of China (NCET-04-0191) and Beijing Natural Sciences Foundation (7052052).

  • Competing interests: None.

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