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Abstract Number: 819

Upregulation of Complement C3 and Alpha-2-Macroglobulin in Cerebrospinal Fluid of Neuropsychiatric Systemic Lupus Erythematosus

Tomoyuki Asano1, Shuzo Sato1, Hiroko Kobayashi1, Yoshinobu Kariya2, Hiromi Ito2, Kyoka Hoshi2, Akioh Yoshihara3, Yoshikazu Ugawa3, Minoru Takahashi4, Hideharu Sekine4, Shunsei Hirohata5, Hiroshi Watanabe1, Hiromasa Ohira1 and Yasuhiro Hashimoto2, 1Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan, 2Biochemistry, Fukushima Medical University School of Medicine, Fukushima, Japan, 3Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan, 4Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan, 5Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Cerebrovascular disease, complement, inflammation and systemic lupus erythematosus (SLE)

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Session Information

Date: Sunday, November 8, 2015

Title: Systemic Lupus Erythematosus - Human Etiology and Pathogenesis Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: Various autoantibodies have been identified in cerebrospinal fluids (CSF) of neuropsychiatric systemic lupus erythematosus (NPSLE). They are supposed to form immune complex with complement to induce inflammatory responses. We therefore measured the 3rd component of complement (C3) and other inflammation-related molecules in CSF of NPSLE patients.

Methods: This study included 51 SLE patients. According to the 1999 ACR definition criteria, 43 patients were diagnosed with NPSLE whereas 8 patients were diagnosed with non-NPSLE. We measured levels of C3, alpha-2-Macroglobulin (α2MG) and IL-6, in CSF or serum by sandwich ELISA.

Results: Quantitative ELISA revealed that the IL-6 levels in CSF of NPSLE (441.9 ± 1233 pg/ml) were significantly higher than that of non-NPSLE (3.36 ± 2.58 pg/ml) (p = 0.0010), which is consistent with the previous observation reported by Hirohata et al. (Clin Rheumatol. 2009). IL-6 is a primary cytokine, which induces various inflammatory responses including complement activation. We examined C3 expression in CSF of NPSLE patients. C3 levels in CSF of NPSLE (4.94 ± 3.79 µg/ml) were significantly higher than that of non-NPSLE (1.92 ± 1.14 µg/ml) (p = 0.0071). It is possible that elevation of C3 in CSF is due to upregulation of serum C3. We therefore analyzed serum levels of C3. No significant difference in serum C3 levels was observed between NPSLE (645 ± 311 µg/ml) and non-NPSLE (824 ± 374 µg/ml) (p = 0.2767). In addition, correlation of C3 levels between CSF and serum was weak in NPSLE (r = 0.2885, p = 0.0380), suggesting that upregulation of C3 in CSF is independent of C3 levels in serum. Another inflammatory protein we analyzed was α2MG, which is a protease inhibitor for localizing proteolytic responses in the inflammatory focus. Quantitative ELISA revealed that levels of α2MG in NPSLE (2.90 ± 3.69 µg/ml) were significantly higher than that of non-NPSLE (0.72 ± 0.26 µg/ml) (p = 0.0010). In contrast, serum levels of α2MG were similar in both specimens. Correlation of α2MG levels between CSF and serum was weak (r = 0.2582, p = 0.0674), suggesting independence of α2MG concentration between CSF and serum. It was notable that CSF levels of C3 and α2MG showed strong correlation (r = 0.6990, p < 0.0001). In addition, that CSF levels of IL-6 was correlated with that of C3 and α2MG, (r = 0.5102, p = 0.0003) and (r = 0.5662, p < 0.0001), respectively, suggesting that IL-6 upregulates C3 and α2MG in CSF.

Conclusion: We demonstrated the increase of IL-6 in CSF of NPSLE patients. IL-6 may upregulate C3 and α2MG in CSF as “local” inflammatory response.


Disclosure: T. Asano, None; S. Sato, None; H. Kobayashi, None; Y. Kariya, None; H. Ito, None; K. Hoshi, None; A. Yoshihara, None; Y. Ugawa, None; M. Takahashi, None; H. Sekine, None; S. Hirohata, None; H. Watanabe, None; H. Ohira, None; Y. Hashimoto, None.

To cite this abstract in AMA style:

Asano T, Sato S, Kobayashi H, Kariya Y, Ito H, Hoshi K, Yoshihara A, Ugawa Y, Takahashi M, Sekine H, Hirohata S, Watanabe H, Ohira H, Hashimoto Y. Upregulation of Complement C3 and Alpha-2-Macroglobulin in Cerebrospinal Fluid of Neuropsychiatric Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/upregulation-of-complement-c3-and-alpha-2-macroglobulin-in-cerebrospinal-fluid-of-neuropsychiatric-systemic-lupus-erythematosus/. Accessed .
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