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a Cattedra e Divisione di Reumatologia, Università La Sapienza, Rome, Italy
Key Words: NPSLE • neuropsychiatric • psychiatric • systemic lupus erythematosus • AECA • Nedd5 • autoantibodies
Address for correspondence: Prof. Guido Valesini, Dipartimento di Clinica e Terapia Medica Applicata, Cattedra di Reumatologia, Università "La Sapienza," V.le del Policlinico 155, 00161 Rome, Italy. Voice: +39 0649974631; fax: +39 0649974642. e-mail: guido.valesini{at}uniroma1.it
The pathogenesis of neuropsychiatric systemic lupus erythematosus (NPSLE) has been attributed to autoantibody-mediated neural dysfunction, vasculopathy, and coagulopathy. Several autoantibodies specificities have been reported in serum and cerebrospinal fluid of NPSLE patients (i.e., antineuronal, antiribosomal P proteins, antiglial fibrillary acidic proteins, antiphospholipid, and anti-endothelial antibodies). We have recently demonstrated an association between serum anti-endothelial antibodies and psychosis or depression in patients with SLE. Subsequently, by screening a cDNA library from human umbilical artery endothelial cells with serum from a SLE patient with psychosis, one positive strongly reactive clone was identified encoding the C-terminal region (C-ter) of Nedd5, an intracytoplasmatic protein of the septin family. Anti-Nedd5 antibodies have been found significantly associated with psychiatric manifestations in SLE patients, strengthening the view of a possible implication of autoantibodies in the development of psychiatric disorders.
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