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Cell-ELISA detection of antineuronal antibodies in central nervous system involvement in systemic lupus erythematosus.

Zhang X, Shu H, Zhang F, Tian X, Dong Y

Department of Rheumatology and Immunology, Peking Union Medical College Hospital, 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.

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.

Published 15 March 2007 in Ann Rheum Dis, 66(4): 530-2.
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Handbook of Meningococcal Disease: Infection Biology, Vaccination, Clinical Management

Handbook of Meningococcal Disease: Infection Biology, Vaccination, Clinical Management