Correlation Of Anti-ribosomal P Protein Antibodies, Anti-phospholipid Antibodies And Neuropsychiatric Lupus

Objective:To explore the relationship of neuropsychiatric lupus (NPSLE) and anti-ribosomal P protein antibodies; and anti-phospholipid antibodies in cerebrospinal fluid and serum.Method:We detected the concentrations of anti-ribosomal P protein antibodies, anti-phospholipid antibodies in cerebrospinal fluid and serum separately for NPSLE group, non-NPSLE group, intracranial infection group, and healthy controls group by ELISA. The measurement data analysis used independent sample t test, rates of small sample used fisher exact test, correlation analysis used Logistic regression. Bilateral P<0.05was considered statistically significant.Results:The concentrations of anti-ribosomal P protein antibodies in cerebrospinal fluid were as follows:3.953±1.392(NPSLE group),2.700±0.576(non-NPSLE group),2.988±0.840(intracranial infection group) and3.062±0.652(healthy controls group). The concentrations of anti-ribosomal P protein antibodies in serum were as follows:15.991±19.709(NPSLE group), 20.712±22.097(non-NPSLE group),3.470±0.761(intracranial infection group) and4.130±2.052(healthy controls group). The concentrations of anti-phospholipid antibodies in cerebrospinal fluid were as follows:133.700±29.980(NPSLE group),177.650±188.296(non-NPSLE group),113.800±8.679(intracranial infection group) and109.300±7.102(healthy controls group). The concentrations of anti-phospholipid antibodies in serum were as follows:513.850±538.582(NPSLE group),670.400±619.335(non-NPSLE group),145.400±77.838(intracranial infection group) and116.350±4.859(healthy controls group).The results of comparison between different groups were as follows:in NPSLE group and non-NPSLE group, the concentrations of anti-ribosomal P protein antibodies and anti-phospholipid antibodies in cerebrospinal fluid and serum were statistically higher than that in intracranial infection group and healthy controls group (P<0.05).Between intracranial infection group and healthy controls group,the concentrations of the two antibodies have no significant difference (P>0.05). the positive rate of anti-Sm antibodies in serum in NPSLE group was statistically higher than that in non-NPSLE group (P<0.05). the positive rate of headache and mood disorders in NPSLE group were statistically higher than that in non-NPSLE group (P<0.05). Demyelination, ischemic lesions and abnormal signal in NPSLE group were statistically higher than that in non-NPSLE group (P<0.05). The results of correlation analysis were as follows:positive correlation were observed between concentrations of anti-phospholipid antibodies in cerebrospinal fluid and the positive rate of patients with headache(OR=2.126;95%CI:1.169～3.867;P<0.05). The higher the concentrations of anti-phospholipid antibodies in cerebrospinal fluid, the higher incidence of occurring headaches.Conclusion:Our study shows that anti-ribosomal P protein antibodies in cerebrospinal fluid and anti-Sm antibodies in serum might be the markers of neuropsychiatric lupus. NPSLE should be strongly suspected in patients with SLE when headache, mood disorders were occurred, and when demyelination, ischemic lesions and abnormal signal performance were found in brain MRI of SLE patients. Headache symptoms in patients with NPSLE may be associated with anti-phospholipid antibodies in cerebrospinal fluid.