Background/Purpose: Autoantibodies against N-methyl-D-aspartate receptor subunit GluN2 (anti-GluN2) in the cerebrospinal fluid are known to be related with the development of diffuse psychiatric/neuropsychological manifestations in NPSLE. However, relation with serum anti-GluN2 antibody (Ab) is unknown. The aim of this study is to clarify the association of damages due to SLE disease activity and serum anti-GluN2 Ab.

Methods: Sera were collected from SLE patients with active disease (N=132), anti-GluN2 Ab were measured in ELISA and clinical information was collected from the past medical history retrospectively.

Results: Patients were subdivided into those complicated with NPSLE (n=37) and those without NPSLE (non-NPSLE) (n=95). Among the NPSLE patients, anti-GluN2 Ab positivity and negativity made no difference in SLEDAI. Whereas, SLEDAI was significantly higher in patients with positive anti-GluN2 Ab (p=0.001) than those with negative within non-NPSLE patients (Fig. 1). In addition, there was significant positive correlation between SLEDAI and anti-GluN2 titers only in non-NPSLE patients (p< 0.001). In univariate analysis using components of SLEDAI, the positivity for anti-GluN2 Ab was a significant risk for complicating pleuritis, arthritis, fever, leukocytopenia, the positivity for anti-dsDNA Abs or hypocomplementemia. Multivariate analysis resulted with high odds ratio (OR) for fever (OR 9.19, 95% confidence interval (CI) 2.42-46.70, p=0.003) and hypocomplementemia (OR 12.74, 95%CI 2.37-103.28, p=0.007) in non-NPSLE patients with positive anti-GluN2 Ab.

Conclusion: Anti-GluN2 existing in serum can be pathogenic autoantibodies, causing damages related to lupus activity even in SLE patients without complicating NPSLE.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-effects-of-anti-glutamate-receptor-subunit-antiantibodies-on-systemic-lupus-erythematosus-without-neuropsychiatric-involvement/