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Abstract Number: 769

Evaluation of Soluble Alpha-Klotho in Neuropsychiatric Systemic Lupus Erythematosus

Kunihiro Ichinose1, Takeshi Ushigusa2, Masataka Umeda1, Tomohiro Koga2, Atsushi Kawakami2 and Shuntaro Sato3, 1Department of Immunology and Rheumatology, Nagasaki University, Nagasaki, Japan, 2Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, 3Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: central nervous system involvement, diagnosis and systemic lupus erythematosus (SLE)

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Session Information

Date: Sunday, November 8, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Evaluation of Soluble alpha-Klotho
in Neuropsychiatric Systemic Lupus Erythematosus

ABSTRACT

Background/Purpose:
Neuropsychiatric systemic lupus erythematosus (NPSLE) is a serious complication
in SLE that presents a variety of symptoms. No reliable diagnostic markers for
NPSLE have been identified, because of the variability of NPSLE manifestations and
the absence of appropriate diagnostic criteria. Alpha-Klotho
is a single-pass transmembrane protein expressed in multiple tissues,
especially brain and kidneys. A reduction of Klotho
protein is known to be associated with endothelial dysfunction and neuronal
damage.

Methods:
We sought to determine whether soluble alpha-Klotho (s-Klotho) in cerebrospinal fluid (CSF) could be a candidate
marker for the diagnosis of NPSLE. We retrospectively analyzed the laboratory
data, symptoms and radiological image findings of patients with NPSLE (n=34)
admitted to our hospital during a 10-year period from 2006 through 2015. Patients
with SLE (n=17), viral meningitis (VM) (n=19), multiple sclerosis (MS) (n=15) or
neuromyelitis optica (NMO)
(n=16) were included as controls. The s-Klotho level in
the CSF of each subject was measured by enzyme-linked immunosorbent assay. We
conducted univariate and multivariable competing-risks regression analyses to
determine the predictive factors for diagnosing NPSLE. We also evaluated a
cutoff value of s-Klotho for the diagnosis of NPSLE by determining the receiver
operating characteristic (ROC) curve.

Results:
There was no significant difference in the clinical background between the NPSLE
and SLE patients. The median CSF s-Klotho level in the
NPSLE, SLE, VM, MS and NMO groups (in pg/mL) were 136.7,
380.2, 302.1, 186.4 and 203.1, respectively. We found that the CSF s-Klotho levels
of the NPSLE patients were significantly lower than those of the other groups. The
multivariable analyses revealed that lower CSF s-Klotho
level (odds ratio [OR], 0.98; 95% confidential interval [CI], 0.96–0.99), lower
anti-Smith antibodies (U/mL) (OR, 0.93; 95%CI, 0.82–0.99) and higher C3 (mg/dL) (OR, 1.08; 95%CI, 1.02–1.18) were significant factors
for predicting NPSLE. The sensitivity and specificity of the CSF s-Klotho level
for the diagnosis of NPSLE were 94.1% and 76.5%, respectively at the cut-off
value of 294.8 pg/mL.

Conclusion: Our
data suggested that lower CSF s-Klotho levels may be associated with the endothelial
dysfunction and neuronal damage in NPSLE patients. The determination of CSF s-Klotho
levels may contribute to the diagnosis of NPSLE and may help elucidate the
mechanisms underlying this disease.


Disclosure: K. Ichinose, None; T. Ushigusa, None; M. Umeda, None; T. Koga, None; A. Kawakami, None; S. Sato, None.

To cite this abstract in AMA style:

Ichinose K, Ushigusa T, Umeda M, Koga T, Kawakami A, Sato S. Evaluation of Soluble Alpha-Klotho in Neuropsychiatric Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/evaluation-of-soluble-alpha-klotho-in-neuropsychiatric-systemic-lupus-erythematosus/. Accessed .
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