Neuropsychiatric systemic lupus erythematosus (NP-SLE) is one of the major cause of morbidity in systemic lupus erythematosus patients and its treatment depends on identification of pathogenic mechanisms. We describe ...Neuropsychiatric systemic lupus erythematosus (NP-SLE) is one of the major cause of morbidity in systemic lupus erythematosus patients and its treatment depends on identification of pathogenic mechanisms. We describe the rare case of neuropsychiatric systemic lupus erythematosus (NP-SLE) complicated by pericardial effusion combined to low C4 level persisting and hyperprolactinaemia. A cyclophosphamide therapy showed a good response in a 21-year old woman with disturbances in thought processes and an acute confusional state with sierositis. This paper confirms that a cyclophosphamide therapy contributes to control a disease activity by a mechanism of prolactin level reduction. Other studies occur to evaluate this hypothesis.展开更多
The pathogenesis of neuropsychiatric syndromes of systemic lupus erythematosus (NPSLE) is multifactorial and can involve various inflammatory cytokines, autoantibodies such as anti-neuronal antibodies, anti-ribosomal ...The pathogenesis of neuropsychiatric syndromes of systemic lupus erythematosus (NPSLE) is multifactorial and can involve various inflammatory cytokines, autoantibodies such as anti-neuronal antibodies, anti-ribosomal P antibodies, anti-NR2 glutamate receptor binding antibodies, anti-Sm antibodies, anti-U1-RNP antibodies and anti-phospholipid antibodies, and immune complexes (IC). Disruption of the blood-brain barrier (BBB) is integral to the neuropathology of SLE. Recently the possibility has been reported that aforementioned autoantibodies in the circulation may be strongly associated with disruption of the BBB. Each of these mechanisms might contribute to the pathogenesis of focal NPSLE (for example, cerebrovascular disease, movement disorders, myelopathy, seizures and cranial neuropathy) or diffuse NPSLE (for example, acute confusional state, psychosis and cognitive dysfunction) to varying degrees. In this review we focus on how the aforementioned autoantibodies, the BBB, IC and cytokines as well as chemokines are associated with the appearance of NPSLE.展开更多
Objective:To investigate the effect of prednisone and cyclophosphamide combine with ligustrazine injection on immunologic function and other related factors in patients with systemic lupus erythematosus (SLE).Methods:...Objective:To investigate the effect of prednisone and cyclophosphamide combine with ligustrazine injection on immunologic function and other related factors in patients with systemic lupus erythematosus (SLE).Methods: The subjects selected 70 patients with SLE who diagnosed and treated in our hospital from March 2014 to May 2018, divided into control group and observation group randomly, 35 cases in each group. The patients in the control group were treated with prednisone combined with cyclophosphamide, and the patients in the observation group was given intravenous drip of ligustrazine injection on the basis of the control group. Before and after treatment, detected and compared the immunologic indexes (IgG, C3, ANA), matrix metalloproteinases (MMP-3, MMP-9, TIMP1), chemotactic factor (CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups.Results: Before treatments, the immunologic indexes(IgG, C3, ANA), matrix metalloproteinases(MMP-3, MMP-9, TIMP1),chemotactic factor(CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups had no statistical significance(P>0.05);After treatments, the immunologic indexes (IgG, C3, ANA), matrix metalloproteinases(MMP-3, MMP-9), chemotactic factor (CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups had statistical significances (P<0.05).Conclusion: Ligustrazine injection was added to SLE patients on the basis of prednisone combined with cyclophosphamide therapy, it not only could significantly improve the immunologic function of patients, but also improve the levels of matrix metalloproteinases, chemokines and related serum factors, it's worthy of clinical research and application.展开更多
1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone ...1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone to concurrent,so early diagnosis and treatment of NPSLE is extremely important.展开更多
Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). M...Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). Methods Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for IT with MTX 10-20?mg plus DXM 10-20?mg. The effects and side effects of IT were closely observed. Results The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving IT improved considerably. Cerebrospinal fluid pressure,protein and WBC levels declined from 201.5±155.4?mm?H2O, 145.2±87.6?mg/dl and 25.1±14.3/mm3 to 128.7±108.1?mm?H2O, 60.8±38.3?mg/dl and 6.8±2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence.Conclusion IT with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.展开更多
Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate...Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE,to screen for the value of conventional MRI in NPSLE.Methods：A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study.All patients were classified into different groups according to MRI abnormalities.Both clinical and immunological features were compared between MRI abnormal and normal groups.One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index （SLEDAI） score for MRI abnormalities.Multivariate logistic regression analysis investigated the correlation between immunological features,neuropsychiatric manifestations,and MRI abnormalities.Results：Thirty-six NPSLE patients （61%） showed a variety of MRI abnormalities.There were statistically significant differences in SLEDAI scores （P 〈 0.001）,incidence of neurologic disorders （P =0.001）,levels of 24-h proteinuria （P =0.001） and immunoglobulin M （P =0.004）,and incidence of acute confusional state （P =0.002）,cerebrovascular disease （P =0.004）,and seizure disorder （P =0.028） between MRI abnormal and normal groups.In the MRI abnormal group,SLEDAI scores for cerebral atrophy （CA）,cortex involvement,and restricted diffusion （RD） were much higher than in the MRI normal group （P 〈 0.001,P =0.002,P =0.038,respectively）.Statistically significant positive correlations between seizure disorder and cortex involvement （odds ratio [OR] =14.90;95% confidence interval [CI],1.50-151.70;P =0.023） and cerebrovascular disease and infratentorial involvement （OR =10.00;95% CI,1.70-60.00;P =0.012） were found.Conclusions：MRI abnormalities in NPSLE,especially CA,cortex involvement,and RD might be markers of high systemic lupus erythematosus activity.Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.展开更多
Objective： To observe the effects of Xuebijing Injection （血必净注射液） on dendritic cells （DCs） and T lymphocytes, and the potential mechanisms of its therapeutic effect on systemic lupus erythematosus （SLE）. ...Objective： To observe the effects of Xuebijing Injection （血必净注射液） on dendritic cells （DCs） and T lymphocytes, and the potential mechanisms of its therapeutic effect on systemic lupus erythematosus （SLE）. Methods： A widely used mouse model, SLE-prone BLLF1 mice aged 8-10 weeks, was employed. Mice were randomly divided into 4 groups： a normal group, a model group and two treatment groups treated with Xuebijing Injection with a dose of 6.4 mL/kg via intraperitoneal administration for SLE-prone BLLF1 mice aged 8 weeks （treatment A group） and 10 weeks （treatment B group）. Renal tissue sections were stained with Masson＇s trichrome and periodic acid-silver methenamine. Histopathological changes in the kidney were evaluated by a light microscopy. The capacity of the DCs isolated from the spleen to stimulate the T cell proliferation in response to concanavalin A （Con A） was determined. Results： Compared with the model group, levels of anti-dsDNA antibodies in the two treatment groups decreased remarkablely （P〈0.01, P〈0.05）, and levels of serum creatinine and blood urea nitrogen increased （P〈0.01, P〈0.05）. Pathological changes were found in the kidney in the model group. Histopathological abnormalities were alleviated in the two treatment groups. Treatment with Xuebijing injection also significantly upregulated the expression of CD80, CD86 and major histocompatibility class Ⅱ by DCs compared with the model group （P〈0.05）. When splenic T lymphocytes from BLLF1 mice were co-cultured with DCs at ratios of 1：100, 1：150 and 1：200 for 3 and 5 days, the proliferation of T lymphocytes was suppressed compared with the normal group （P〈0.05）, but this was restored by Xuebijing Injection under the same conditions. In the model group, levels of tumor necrosis factor （TNF）-α in supernatants were significantly elevated compared with the normal group （P〈0.01）, interleukin-2 levels decreased （P〈0.05）, while these changes were significantly alleviated in the Xuebijing treatment groups. Conclusions： Xuebijing Injection alleviated renal injury in SLE-prone BLLF-1 mice. The mechanism might be through influencing T cell polarization mediated by DCs, and Xuebijing Injection might be a potential drug that suppresses immune dysfunction in patients with SLE.展开更多
目的:采用网络药理学和分子对接的研究方法,探究白芍治疗系统性红斑狼疮脑病(NPSLE)的有效成分及作用机制。方法:利用中药系统药理学数据库与分析平台(TCMSP)筛选白芍生物活性成分及潜在靶点;运用Genecards数据库收集NPSLE的疾病靶点;...目的:采用网络药理学和分子对接的研究方法,探究白芍治疗系统性红斑狼疮脑病(NPSLE)的有效成分及作用机制。方法:利用中药系统药理学数据库与分析平台(TCMSP)筛选白芍生物活性成分及潜在靶点;运用Genecards数据库收集NPSLE的疾病靶点;利用在线韦恩图绘制平台Venny2.1得到二者共同的靶点,将共同靶点导入STRING数据库构建蛋白质相互作用网络,并利用Cytoscape3.8.0进行可视化处理;通过Metascape在线软件对靶点进行基因本体(Gene Ontology,GO)分析、京都基因与基因组百科全书(Kyoto Encylopaedia of Genes and Genomes,KEGG)通路富集分析,探究相关的生物过程与信号通路;应用Cytoscape3.8.0构建“成分—靶点—通路”网络;最后通过AutoDock软件对药物的主要活性成分及核心作用靶点进行分子对接验证。结果:共获得白芍的13个化学成分、70个潜在作用靶点和740个NPSLE相关作用靶点,其中白芍与NPSLE共同作用靶点有31个;PPI网络显示处于核心地位的靶点为白细胞介素(IL)-6、肿瘤坏死因子(TNF)、CASP3等,KEGG通路富集分析筛选得到83条与白芍治疗NPSLE相关通路,主要作用于IL-17信号通路、TNF信号通路、流体剪切应力和动脉粥样硬化、细胞凋亡、雌激素信号通路等。分子对接结果显示,主要活性成分能够分别与代表性的靶点结合并展现出较好的亲和力。结论:白芍对通过“多成分—多靶点—多途径”的特点与优势作用于NPSLE,为中医药治疗NPSLE的临床应用奠定了基础。展开更多
文摘Neuropsychiatric systemic lupus erythematosus (NP-SLE) is one of the major cause of morbidity in systemic lupus erythematosus patients and its treatment depends on identification of pathogenic mechanisms. We describe the rare case of neuropsychiatric systemic lupus erythematosus (NP-SLE) complicated by pericardial effusion combined to low C4 level persisting and hyperprolactinaemia. A cyclophosphamide therapy showed a good response in a 21-year old woman with disturbances in thought processes and an acute confusional state with sierositis. This paper confirms that a cyclophosphamide therapy contributes to control a disease activity by a mechanism of prolactin level reduction. Other studies occur to evaluate this hypothesis.
文摘The pathogenesis of neuropsychiatric syndromes of systemic lupus erythematosus (NPSLE) is multifactorial and can involve various inflammatory cytokines, autoantibodies such as anti-neuronal antibodies, anti-ribosomal P antibodies, anti-NR2 glutamate receptor binding antibodies, anti-Sm antibodies, anti-U1-RNP antibodies and anti-phospholipid antibodies, and immune complexes (IC). Disruption of the blood-brain barrier (BBB) is integral to the neuropathology of SLE. Recently the possibility has been reported that aforementioned autoantibodies in the circulation may be strongly associated with disruption of the BBB. Each of these mechanisms might contribute to the pathogenesis of focal NPSLE (for example, cerebrovascular disease, movement disorders, myelopathy, seizures and cranial neuropathy) or diffuse NPSLE (for example, acute confusional state, psychosis and cognitive dysfunction) to varying degrees. In this review we focus on how the aforementioned autoantibodies, the BBB, IC and cytokines as well as chemokines are associated with the appearance of NPSLE.
文摘Objective:To investigate the effect of prednisone and cyclophosphamide combine with ligustrazine injection on immunologic function and other related factors in patients with systemic lupus erythematosus (SLE).Methods: The subjects selected 70 patients with SLE who diagnosed and treated in our hospital from March 2014 to May 2018, divided into control group and observation group randomly, 35 cases in each group. The patients in the control group were treated with prednisone combined with cyclophosphamide, and the patients in the observation group was given intravenous drip of ligustrazine injection on the basis of the control group. Before and after treatment, detected and compared the immunologic indexes (IgG, C3, ANA), matrix metalloproteinases (MMP-3, MMP-9, TIMP1), chemotactic factor (CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups.Results: Before treatments, the immunologic indexes(IgG, C3, ANA), matrix metalloproteinases(MMP-3, MMP-9, TIMP1),chemotactic factor(CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups had no statistical significance(P>0.05);After treatments, the immunologic indexes (IgG, C3, ANA), matrix metalloproteinases(MMP-3, MMP-9), chemotactic factor (CXCL9, CXCL10, CXCL11) and serum levels of IL-10, PRL, S100 protein and EET between the two groups had statistical significances (P<0.05).Conclusion: Ligustrazine injection was added to SLE patients on the basis of prednisone combined with cyclophosphamide therapy, it not only could significantly improve the immunologic function of patients, but also improve the levels of matrix metalloproteinases, chemokines and related serum factors, it's worthy of clinical research and application.
基金Guangdong Obers Blood Purification Academician Work station(2013B090400004)Construction of collaborative platform for clinical research and clinical research of blood purifica tion(201604020175)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong University blood purification technology and Engineering Re search Center(GCZX-A1104)Guangdong Provincial Center for clinical engineering of blood purification(507204531040)
文摘1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone to concurrent,so early diagnosis and treatment of NPSLE is extremely important.
文摘Abstract:Objective To investigate the effect of intrathecal injection (IT) with methotrexate (MTX) plus dexamethasone (DXM) in treating central nervous system involvement in systemic lupus erythematosus (CNS lupus). Methods Twenty-four CNS lupus patients that were refractory to conventional steroid therapy were selected for IT with MTX 10-20?mg plus DXM 10-20?mg. The effects and side effects of IT were closely observed. Results The symptoms and signs of 22/24 (91.7%) CNS lupus patients receiving IT improved considerably. Cerebrospinal fluid pressure,protein and WBC levels declined from 201.5±155.4?mm?H2O, 145.2±87.6?mg/dl and 25.1±14.3/mm3 to 128.7±108.1?mm?H2O, 60.8±38.3?mg/dl and 6.8±2.1/mm3 respectively. Transient side effects were observed in 4 patients: 1 with itching sensation of lower limbs, 2 with headache and 1 with incontinence.Conclusion IT with MTX plus DXM is a promising method for treating CNS lupus and deserves further investigation.
基金This study was supported by the Provincial Natural Science Foundation of Shandong
文摘Background：Conventional magnetic resonance imaging （MRI） is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus （NPSLE）.The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE,to screen for the value of conventional MRI in NPSLE.Methods：A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study.All patients were classified into different groups according to MRI abnormalities.Both clinical and immunological features were compared between MRI abnormal and normal groups.One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index （SLEDAI） score for MRI abnormalities.Multivariate logistic regression analysis investigated the correlation between immunological features,neuropsychiatric manifestations,and MRI abnormalities.Results：Thirty-six NPSLE patients （61%） showed a variety of MRI abnormalities.There were statistically significant differences in SLEDAI scores （P 〈 0.001）,incidence of neurologic disorders （P =0.001）,levels of 24-h proteinuria （P =0.001） and immunoglobulin M （P =0.004）,and incidence of acute confusional state （P =0.002）,cerebrovascular disease （P =0.004）,and seizure disorder （P =0.028） between MRI abnormal and normal groups.In the MRI abnormal group,SLEDAI scores for cerebral atrophy （CA）,cortex involvement,and restricted diffusion （RD） were much higher than in the MRI normal group （P 〈 0.001,P =0.002,P =0.038,respectively）.Statistically significant positive correlations between seizure disorder and cortex involvement （odds ratio [OR] =14.90;95% confidence interval [CI],1.50-151.70;P =0.023） and cerebrovascular disease and infratentorial involvement （OR =10.00;95% CI,1.70-60.00;P =0.012） were found.Conclusions：MRI abnormalities in NPSLE,especially CA,cortex involvement,and RD might be markers of high systemic lupus erythematosus activity.Some MRI abnormalities might correspond to neuropsychiatric manifestations and might be helpful in understanding the pathophysiology of NPSLE.
基金Supported by Grants from the National Natural Science Foundation(No.81130035,81071545,and 30971192)the National Basic Research Program of China(No. 2012CB518102)
文摘Objective： To observe the effects of Xuebijing Injection （血必净注射液） on dendritic cells （DCs） and T lymphocytes, and the potential mechanisms of its therapeutic effect on systemic lupus erythematosus （SLE）. Methods： A widely used mouse model, SLE-prone BLLF1 mice aged 8-10 weeks, was employed. Mice were randomly divided into 4 groups： a normal group, a model group and two treatment groups treated with Xuebijing Injection with a dose of 6.4 mL/kg via intraperitoneal administration for SLE-prone BLLF1 mice aged 8 weeks （treatment A group） and 10 weeks （treatment B group）. Renal tissue sections were stained with Masson＇s trichrome and periodic acid-silver methenamine. Histopathological changes in the kidney were evaluated by a light microscopy. The capacity of the DCs isolated from the spleen to stimulate the T cell proliferation in response to concanavalin A （Con A） was determined. Results： Compared with the model group, levels of anti-dsDNA antibodies in the two treatment groups decreased remarkablely （P〈0.01, P〈0.05）, and levels of serum creatinine and blood urea nitrogen increased （P〈0.01, P〈0.05）. Pathological changes were found in the kidney in the model group. Histopathological abnormalities were alleviated in the two treatment groups. Treatment with Xuebijing injection also significantly upregulated the expression of CD80, CD86 and major histocompatibility class Ⅱ by DCs compared with the model group （P〈0.05）. When splenic T lymphocytes from BLLF1 mice were co-cultured with DCs at ratios of 1：100, 1：150 and 1：200 for 3 and 5 days, the proliferation of T lymphocytes was suppressed compared with the normal group （P〈0.05）, but this was restored by Xuebijing Injection under the same conditions. In the model group, levels of tumor necrosis factor （TNF）-α in supernatants were significantly elevated compared with the normal group （P〈0.01）, interleukin-2 levels decreased （P〈0.05）, while these changes were significantly alleviated in the Xuebijing treatment groups. Conclusions： Xuebijing Injection alleviated renal injury in SLE-prone BLLF-1 mice. The mechanism might be through influencing T cell polarization mediated by DCs, and Xuebijing Injection might be a potential drug that suppresses immune dysfunction in patients with SLE.
文摘目的:采用网络药理学和分子对接的研究方法,探究白芍治疗系统性红斑狼疮脑病(NPSLE)的有效成分及作用机制。方法:利用中药系统药理学数据库与分析平台(TCMSP)筛选白芍生物活性成分及潜在靶点;运用Genecards数据库收集NPSLE的疾病靶点;利用在线韦恩图绘制平台Venny2.1得到二者共同的靶点,将共同靶点导入STRING数据库构建蛋白质相互作用网络,并利用Cytoscape3.8.0进行可视化处理;通过Metascape在线软件对靶点进行基因本体(Gene Ontology,GO)分析、京都基因与基因组百科全书(Kyoto Encylopaedia of Genes and Genomes,KEGG)通路富集分析,探究相关的生物过程与信号通路;应用Cytoscape3.8.0构建“成分—靶点—通路”网络;最后通过AutoDock软件对药物的主要活性成分及核心作用靶点进行分子对接验证。结果:共获得白芍的13个化学成分、70个潜在作用靶点和740个NPSLE相关作用靶点,其中白芍与NPSLE共同作用靶点有31个;PPI网络显示处于核心地位的靶点为白细胞介素(IL)-6、肿瘤坏死因子(TNF)、CASP3等,KEGG通路富集分析筛选得到83条与白芍治疗NPSLE相关通路,主要作用于IL-17信号通路、TNF信号通路、流体剪切应力和动脉粥样硬化、细胞凋亡、雌激素信号通路等。分子对接结果显示,主要活性成分能够分别与代表性的靶点结合并展现出较好的亲和力。结论:白芍对通过“多成分—多靶点—多途径”的特点与优势作用于NPSLE,为中医药治疗NPSLE的临床应用奠定了基础。
