care for Lupus

Particular immune molecules and NPSLE

Tuesday, March 25, 2008

What is the topic?

Despite the fact that a significant percentage of lupus patients (estimates run from 14% to 75%) have signs of neurological involvement, doctors still don’t have a single test that can definitely indicate when lupus is affecting the central nervous system (NPSLE).

What did the researchers hope to learn?

The researchers sought to determine if the presence of particular factors in the spinal fluid (CSF) of lupus patients are associated with NPSLE, which might help determine NPSLE diagnosis.

Who was studied?

The study had four different groups of subjects who were patients at the same hospital in Mexico City: 42 lupus patients who had symptoms of NPSLE; six lupus patients with septic meningitis; 16 lupus patients with no symptoms of NPSLE; and 25 patients with no autoimmune disease and no neurological manifestations who were undergoing elective surgery.

How was the study conducted?

All of the patients agreed to participate in the study and to undergo a spinal tap. Six months after hospitalization, a second spinal tap was done on 30 of the 42 NPSLE patients.
The researchers compared the CSF samples of the NPSLE patients with those of the other groups They also compared the samples of the NPSLE patients that were taken six months later, after the patients had undergone medical treatment and no longer had any NPSLE symptoms.

What did the researchers find?

The researchers found increased concentrations of several inflammatory proteins in the CSF of lupus patients during a flare of NPSLE including interleukin 6 (IL-6) and several other proteins. At the six-month follow-up, levels of these inflammatory proteins had decreased significantly, but not completely, and were now similar to lupus patients who did not have NPSLE.
What were the limitations of the study?The researchers did not study any group of patients with neurologic symptoms but no autoimmune disease, so it is impossible to determine if the high levels of the compounds they identified were present because of the NPSLE or the general fact that there was neurological involvement.

What do the results mean for you?

Though further studies are required, this research does suggest a particular blood test that could be useful in determining when lupus involves the nervous system. It also provides an interesting perspective on the different ways lupus can affect tissues and cells depending on where they are located in the body and the functions they perform.

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Labels: chemokines, Interleukin-6, neuropsychiatric, NPSLE, systemic lupus erythematosus