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FRI0397 Relationship between Igg Anti-Nr2 Glutamate Receptor Antibodies and Depressive/Anxiety Symptoms in Patients with Systemic Lupus Erythematosus
  1. C.C. Mok1,
  2. K.L. Chan1,
  3. B. Diamond2
  1. 1Medicine, Tuen Mun Hospital, Hong Kong, Hong Kong
  2. 2Center for Autoimmune and Musculoskeletal Diseases, the Feinstein Institute for Medical Research, New York, United States

Abstract

Objectives To study the relationship between anti-NR2 glutamate receptor antibodies (anti-NR2) and depressive/anxiety symptoms in patients with systemic lupus erythematosus (SLE).

Methods Consecutive Chinese patients who fulfilled ≥4 ACR criteria for SLE were recruited. Depressive/anxiety symptoms were assessed by the validated Chinese version of the Hospital Anxiety and Depression scale (HADS) (0-21 points). Serum samples were taken at 10am in the morning for the assay of anti-NR2 antibodies (in-house ELISA using peptide adsorbed to plate and serum diluted 1:100, developed with an anti-human IgG antibody). Disease activity of patients recruited was assessed by SLEDAI and physicians' global assessment (PGA), whereas organ damage since SLE diagnosis was assessed by the ACR/SLICC damage index (SDI). Correlation among anti-NR2 titer, age, sex, HADS-depression score, HADS-anxiety score, SLEDAI, PGA and SDI in various systems was studied by linear regression models.

Results 285 SLE patients were studied (95% women; age 38.9±12.6 years; SLE duration 9.0±7.0 years). At the time of study, 57 (20%) patients had clinically active SLE (SLEDAI ≥5); and 106 (37%) patients had organ damage (SDI score ≥1). The mean SLEDAI was 3.9±4.6 and the mean PGA was 0.36±0.66. Forty-four (15%) patients had HADS-anxiety score of >10 and 28 (9.8%) of patients had HADS-depression score of >10. Anti-NR2 antibodies were present in 154 (54%) patients, defined as titers of greater than the mean+2SD (standard deviation) of healthy controls. Strongly positive values of anti-NR2 (defined as mean+4SD of controls) were found in 90 (32%) patients. Linear regression revealed that anti-NR2 reactivity correlated with SLEDAI score (Beta 0.25; p<0.001), PGA score (Beta 0.31; p<0.001), mean SLEDAI in the preceding 12 months (Beta 0.18; p=0.003), C3 level (Beta -0.25; p<0.001), HADS-depression score (Beta 0.14; p=0.022) and HADS-anxiety score (Beta 0.14; p=0.023), adjusted for age and sex. There was no relationship between anti-NR2 titers and anti-dsDNA titer, total SDI damage score (Beta 0.09; p=0.14), neuropsychiatric damage (Beta 0.06; p=0.32) or SDI scores in other systems.

Conclusions Anti-NR2 antibodies are prevalent in patients with SLE. Anti-NR2 reactivity correlated with disease activity and depressive/anxiety symptoms in SLE patients.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2633

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