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272 Clinical significance of anti-dna/nr2 antibodies in de novo npsle and post-steroid npsle
  1. Y Fujieda1,
  2. S Mader2,
  3. V Jegnathan2,
  4. Y Arimuna2,
  5. Y Shimizu1,
  6. M Kato1,
  7. K Oku1,
  8. T Bohgaki1,
  9. O Amengual1,
  10. S Yasuda1,
  11. B Diamond2 and
  12. T Atsumi1
  1. 1Hokkaido University Graduate School of Medicine, Division of Rheumatology- Endocrinology and Nephrology, Sapporo, Japan
  2. 2The Feinstein Institute for Medical Research, Centre of Autoimmune and Musculoskeltal Diseases, New York, USA


Background and aims Anti-DNA/NR2 antibodies are a subset of anti DNA autoantibodies that cross-react with the extracellular domain of the GluN2A/GluN2B subunits of the N-methyl-d-aspartate receptor 2 (NR2), which induce apoptosis of hippocampus neurons and psychiatric disorder in mice and humans. Neuropsychiatric SLE (NPSLE) can develop after initiation of steroid (post-steroid neuropsychiatric manifestation: PSNP) or before treatment (de novo NPSLE). The objective of this study was to clarify the prevalence of anti-DNA/NR2 antibodies in PSNP-SLE and de novo NPSLE

Methods This study involved a cohort of patients with NPSLE who were admitted to Hokkaido University Hospital. NPSLE patients were classified into two groups, de novo NPSLE and PSNP-SLE. Serum anti-DNA antibodies and anti-DNA/NR2 antibodies were measured using in-house ELISAs.

Results Serum samples were obtained from 29 patients with de novo NPSLE, 26 with PSNP-SLE and 83 healthy controls (HC). The levels of anti-DNA antibodies in patients with de novo NPSLE and PSNP-SLE were significantly higher than those in healthy controls (de novo NPSLE, PSNP-SLE, HC: 1.34±0.09, 1.40±0.14, 0.33±0.03, p<0.0001). The levels of anti-DNA/NR2 antibodies were highest in de novo NPSLE and in PSNP-SLE and HC (de novo NPSLE, PSNP-SLE, HC: 0.75±0.10, 0.60±0.07, 0.49±0.03). In PSNP-SLE, the frequency of mood disorders was higher than that in de novo NPSLE (58% vs 31% p<0.05).

Conclusions The levels of anti-DNA/NR2 in PSNP-SLE are lower than in de novo NPSLE, indicating the differences in the pathogenesis of these two conditions.

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