The Significance Of Anti-ubiquitin Carboxy-terminal Hydrolase-1 Antibody In Neuropsychiatric Systemic Lupus Erythematosus

Background and ObjectiveSystemic lupus erythematosus(SLE)is a chronic autoimmune disease mediated by autoimmune mechanisms that involves multiple systems and multiple organs.It is characterized by multiple autoantibodies production and diverse clinical symptoms.Among them,systemic lupus erythematosus patients with one or more neuropsychiatric symptoms are called neuropsychiatric systemic lupus erythematosus(NPSLE).Neuropsychiatric lupus is one of the more severe types of SLE and can occur at any stage before or during the onset of SLE with a poor prognosis.The pathogenesis of NPSLE is not yet completely clear and is generally believed to be related to vascular lesions,autoantibody production,inflammatory reactions,abnormal coagulation,and the like.There is currently a lack of specific diagnostic tools in clinic.Ubiquitin carboxy-terminal hydrolase-1(UCHL-1)is a member of the ubiquitin C-terminal hydrolase family.It is a neuronal cytoplasmic protein composed of 233 amino acids,which is mainly distributed in brain tissue,and a small amount can also be secreted by gonads,damaged or clonal cells.At present,studies on UCHL-1 mostly focus on craniocerebral injury and degenerative changes,and there are few studies on neuropsychiatric lupus.Anti-UCHL-1 antibody is the autoantibody of neuronal cytoplasmic protein.At present,there are few domestic and overseas studies on anti-UCHL-1 antibody for clinical diagnosis.In this study,indirect enzyme-linked immunosorbent assay was used to detect the anti-UCHL-1 antibody level in cerebrospinal fluid of patients,and to retrospectively analyze the clinical data of anti-UCHL-1 antibody-positive patients,aiming to explore its diagnostic value in NPSLE.Methods1.patients and samplesReference was made to the SLE diagnostic criteria developed by the American College of Rheumatology in 1997 and the NPSLE diagnostic criteria developed by the American College of Rheumatology in 1999.The cerebrospinal fluid of patients with systemic lupus erythematosus admitted to the Fifth Affiliated Hospital of Zhengzhou University and neuropsychiatric disorders admitted to the neurology department of Peking University People's Hospital were collected.2.the collection of clinical dataCreate raw data tables and access case data in the electronic medical record system.3.UCHL-1 protein synthesisUCHL-1 protein is commissioned by Biotech to synthesis of the protein.4.groupingThe experiment was divided into SLE group,NPSLE group,nerve disease control group to detect cerebrospinal fluid.5.anti-UCHL-1 antibody assayIndirect enzyme-linked immunosorbent assay(ELISA)was used to detect anti-UCHL-1 antibodies in cerebrospinal fluid.6.statistical analysisSPSS 21 analysis software and Flowjo software were used for statistical analysis.Results1.The levels of anti-UCHL-1 autoantibody were significant higher in the NPSLE patients than the other controls(P<0.05).The positive rate of anti-UCHL-1 autoantibody was 23.7%(9/38),which was much higher than the control groups(0%).2.A significant difference of anti-UCHL-1 autoantibody was observed in the patients with blood system involvement(P=0.012).3.The positive rates of anti-UCHL autoantibodies were 41.7%,29.4%,29.2%,25.9%,25.0%,25.0% in the negative SLE related autoantibodies including AnuA,anti-dsDNA,ACL,anti-nRNP,anti-rRNP and anti-Sm antibody negative,respectively.The levels of anti-UCHL-1 autoantibody had a positive correlation with 24-hours proteinuria(r=0.361,P=0.039).Conclusions Anti-UCHL-1 antibody has a certain significance in the diagnosis of NPSLE.