Tumor necrosis factor receptor 2 and anti-ribosomal P antibodies as biomarkers in juvenile neuropsychiatric systemic lupus erythematosus

Abstract

Background: Neuropsychiatric systemic lupus erythematosus (NPSLE) is more frequent in adolescents than in adults and is indistinguishable from regular mood disorders. Aim: To investigate the levels of soluble tumor necrosis factor receptor 2 (sTNFR2) and anti-ribosomal P (anti-rib-p) antibodies in the serum of adolescents suffering from juvenile lupus and their correlation with neuropsychiatric manifestations (NP) and disease activity. Methods: Sixty adolescents diagnosed with systemic lupus erythematosus (SLE) visiting Ain Shams University hospitals were assessed for NPSLE. Subjects were divided into 3 groups. Group 1 comprised 30 patients suffering from NP manifestations, while group 2 included 30 patients without NP manifestations. Computerized Axial Tomography (CAT) scans of the brain were done for NPSLE patients to exclude organic disease. Group 3 comprised 30 age and gender-matched healthy adolescents. Lupus activity was evaluated by the Systemic Lupus Disease Activity Index (SLEDAI). Levels of sTNFR2 and anti-rib-P antibodies were analyzed using enzyme-linked immunosorbent assay (ELISA). Results: The levels of sTNFR2 and anti-rib-P antibodies were significantly higher (P < 0.0001) in lupus patients compared to healthy subjects. Anti-rib-P antibodies levels were significantly higher in patients with NPSLE compared to those without NPSLE. Levels of sTNFR2 correlated positively with SLEDAI and ESR. Similar correlations were observed for anti-rib-P antibodies. Conclusion: The study showed that anti-rib-P antibodies could be used as biomarkers for the early diagnosis of NPSLE and sTNFR2 could be a valuable marker for the evaluation of juvenile lupus activity.

Keywords

• Juvenile neuropsychiatric systemic lupus erythematosus
• Tumor necrosis factor receptor 2
• Anti-ribosomal P antibodies