Session Information
Date: Tuesday, November 10, 2015
Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment V: Neuropsychiatric Lupus
Session Type: ACR Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background/Purpose:
Peripheral neurologic syndromes and central nervous system (CNS) manifestations are recognized as primary disease manifestations in systemic lupus erythematosus (SLE). Neuropsychiatric SLE (NPSLE) involves a wide range of nervous system disorders, and can affect 50% or more of SLE patients(1). There is no single diagnostic test specific for NPSLE; rather, the diagnosis is currently based on the combined use of serological testing, functional and/or structural neuroimaging, and standardized neurological and neuropsychological assessments(1). A sensitive and specific serological biomarker for NPSLE would be very helpful in the management of lupus patients. Using a novel antigen microarray platform, unique multivariate classification models were developed to distinguish between patients with NPSLE and SLE patients without active neuropsychiatric manifestations (non-NPSLE).
Methods:
Thirty-eight SLE serum samples were obtained from the Einstein Lupus Cohort at the Albert Einstein College of Medicine (Bronx, NY) and tested using the ImmunArray iCHIP®(2), printed with a set of 225 antigens associated with SLE and/or brain injury. All SLE samples satisfied the ACR classification criteria. Twelve of the 38 patients were diagnosed as positive for NPSLE based on the use of a validated questionnaire (3). Two independent classification methods were developed. Classifier training and testing were performed based on 5-fold cross validation on all samples.
Results:
Both classification methods differentiated between the lupus patients with and without neuropsychiatric symptoms. The support vector machine (SVM) classification model performed with sensitivity greater than 99% and specificity of 88%. The logistic regression method separated the populations with 83% sensitivity and 96% specificity. Several auto-antigens were shared between the two models, increasing the confidence in the selected antigen lists.
Conclusion:
In a proof of concept study, classification methods based on autoantibody profiles from the ImmunArray iCHIP® were able to successfully distinguish between lupus patients with and without neuropsychiatric symptoms. Our preliminary results based on 38 patients are very promising and warrant additional validation in a larger cohort of NPSLE patients.
References:
(1) Hermosillo-Romo D, Brey RL; Best Pract Res Clin Rheumatol. 2002 Apr;16(2):229-44
(2) Fattal, I, et al; Immunology 2010, 130, 337-343
(3) M Mosca et at.; Lupus (2011) 20, 485–492
Acknowledgements: The authors wish to acknowledge the invaluable contributions of Ornit Cohen-Gindi, Miriam Lerner, Naama Shefer, Ilana Gilkaite, Angela Turner and Nazanin Mishrani
To cite this abstract in AMA style:
Putterman C, Batty DS, Cohen IR, Jordan N, Rybak D, Rubinstein T, Jakobi K, Sorek R, Reiner-Benaim A, Blumenstein Y, Safer P. Serologic Diagnosis of Human Neuropsychiatric Lupus Using the Immunarray ICHIP® [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/serologic-diagnosis-of-human-neuropsychiatric-lupus-using-the-immunarray-ichip/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/serologic-diagnosis-of-human-neuropsychiatric-lupus-using-the-immunarray-ichip/