Vol.19 No.5

Review Article

Pathogenesis of neuropsychiatric systemic lupus erythematosus and potential biomarkers

Authors

Petros Efthimiou1,2 , Michelle Blanco3

  • Rheumatology Division, Lincoln Medical and Mental Health Center, 234 E. 149th Street, New York, NY 10451, USA
  • Department of Medicine, Weill Cornell Medical College, New York, NY, USA
  • UCLA Department of Family Medicine, Les Kelley Family Health Center, 1920 Colorado Avenue, Santa Monica, CA 90404, USA
Received:

6 March 2009

Accepted:

9 June 2009

Published online:

18 July 2009

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Abstract

Systemic lupus erythematosus is a chronic, multisystemic, autoimmune disease that may involve the central, peripheral, and autonomic nervous systems and can present with a wide variety of neurological and psychiatric manifestations. In this article, we review the recent literature pertaining to the pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE). We searched the PUBMED database with no chronological constraints using the following terms: “neuropsychiatric systemic lupus erythematosus” cross-referenced with the terms “pathogenesis” and “biomarkers” for full-text articles in English. The etiology of NPSLE is as yet unknown, though numerous autoantibodies and cytokines have been suggested as possible mediators. Of the numerous autoantibodies and biomarkers examined, anti-phospholipid, anti-ribosomal P, anti-neuronal, anti-glial fibrillary acidic protein (GFAP), anti-endothelial cell, anti-N-methyl-d-aspartate (NMDA), microtubule-associated protein 2 (MAP-2), and matrix metalloproteinase-9 (MMP-9) appear to be elevated in patients with NPSLE. Cytokines that may be involved in the pathology of NPSLE include interleukin (IL)-2, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, and interferons (IFN)-α and -γ. With continued advances in immunological research, new insights into the pathophysiologic mechanisms of NPSLE may lead to the development of biomarkers and new treatment strategies.

Key words

Neuropsychiatric systemic lupus erythematosus - NPSLE - CNS lupus - Autoantibodies - Cytokines