Journal
RHEUMATOLOGY
Volume 50, Issue 9, Pages 1578-1585Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keq408
Keywords
Systemic lupus erythematosus; N-methyl-d-aspartate receptor; Neuropsychiatric involvement; Autoantibody
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Funding
- Ministry of Health, Labour and Welfare in Japan
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Objective. The aim of this study is to establish a detection method for anti-N- methyl-D-aspartate receptor subunit 2A (NR2A) antibody and to evaluate the relationship between anti-NR2A antibody and various organ involvement in SLE. Methods. Serum anti-NR2A antibody was measured by ELISA using a peptide with a core of either DWEYS or DWDYS as autoantigen. Additionally, clinical characteristics were compared between 27 anti-NR2A antibody-positive (P group) and 80 antibody-negative (N group) SLE patients using DWDYS peptide. Results. The optical density (OD) values of anti-NR2A antibody using DWDYS and DWEYS peptides correlated significantly (r = 0.94, P < 0.0001). The median OD value was significantly higher (P < 0.0001) with DWDYS. Additionally, the SLEDAI was significantly higher (P = 0.023) in the P group. The frequency of neuropsychiatric SLE (NPSLE) was significantly higher (P = 0.0002) in the P group, although the frequencies of serositis and nephritis were not statistically significant. Significant correlations were found between anti-NR2A antibody and leucocyte count (r(s) = -0.31, P = 0.001) and haemoglobin (r(s) = -0.42, P < 0.0001), although no correlation was found between anti-NR2A antibody and the titre of anti-dsDNA antibody. NPSLE was the most significant independent variable (P = 0.0008) associated with anti-NR2A antibody positivity, as estimated by multiple linear regression analysis. Conclusion. Serum anti-NR2A antibody can be associated with the complication of NPSLE and may indicate the involvement of non-nervous tissue. The use of peptides that include DWDYS is preferable to detect anti-NR2A antibody in ELISA.
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