Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus: A predominantly population-based study

Nasrin Asgari, Sven Jarius, Helle Laustrup, Hanne P.B. Skejoe, Soeren T. Lillevang, Brian G Weinshenker, Anne Voss

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Serum immunoglobulin G targeting the astrocyte water channel aquaporin-4 (AQP4) in the central nervous system (CNS) is a biomarker for neuromyelitis optica spectrum disease (NMOSD). Co-existence of NMOSD with systemic lupus erythematosus (SLE) putatively suggests susceptibility to antibody-mediated autoimmune disease. Objective: To estimate the prevalence of NMOSD in SLE and investigate the immunogenetic background for an association of NMOSD and SLE. Methods: The study included a predominantly population-based cohort with clinical and serological investigations of 208 patients with SLE, followed prospectively since 1995. All patients received immunosuppressive treatment. NMOSD was evaluated retrospectively based on the 2015 International Panel for NMOSD Diagnosis (IPND) criteria. Polymorphisms in programmed cell death protein 1 (PDCD-1) PD-1.3 G/A were genotyped. AGP4-IgG and other autoantibodies, including myelin oligodendrocyte glycoprotein (MOG), was determined blinded to clinical diagnosis. Results: Of 208 patients with SLE, 45(22%) had neuropsychiatric (NP) SLE, and CNS involvement predominated in 30 of 45 (67%) patients. Serum AQP4-IgG was detected in 2 of 30 (6.7%) neuropsychiatric SLE (NPSLE) patients both of whom had myelitis and antiphospholipid syndrome; one patient also had myasthenia gravis. None had MOG-IgG. PD-1.3A allele was not associated with SLE nor with NPSLE. Conclusion: AQP4-IgG autoimmune syndrome may rarely co-exist with SLE, and such patients have other NMOSD-typical syndromes such as myelitis.

Original languageEnglish (US)
Pages (from-to)331-339
Number of pages9
JournalMultiple Sclerosis Journal
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Aquaporin 4
Neuromyelitis Optica
Autoimmunity
Systemic Lupus Erythematosus
Immunoglobulin G
Population
Central Nervous System Lupus Vasculitis
Myelin-Oligodendrocyte Glycoprotein
Myelitis
Programmed Cell Death 1 Receptor
Central Nervous System
Immunogenetics
Aquaporins
Antiphospholipid Syndrome
Myasthenia Gravis
Immunosuppressive Agents
Serum
Astrocytes
Autoantibodies
Autoimmune Diseases

Keywords

  • aquaporin-IgG
  • Epidemiology
  • myelin oligodendrocyte glycoprotein-IgG
  • neuromyelitis optica spectrum disease
  • programmed death 1
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus : A predominantly population-based study. / Asgari, Nasrin; Jarius, Sven; Laustrup, Helle; Skejoe, Hanne P.B.; Lillevang, Soeren T.; Weinshenker, Brian G; Voss, Anne.

In: Multiple Sclerosis Journal, Vol. 24, No. 3, 01.03.2018, p. 331-339.

Research output: Contribution to journalArticle

Asgari, Nasrin ; Jarius, Sven ; Laustrup, Helle ; Skejoe, Hanne P.B. ; Lillevang, Soeren T. ; Weinshenker, Brian G ; Voss, Anne. / Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus : A predominantly population-based study. In: Multiple Sclerosis Journal. 2018 ; Vol. 24, No. 3. pp. 331-339.
@article{f92cfb4994d54729800e493f7f49973c,
title = "Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus: A predominantly population-based study",
abstract = "Background: Serum immunoglobulin G targeting the astrocyte water channel aquaporin-4 (AQP4) in the central nervous system (CNS) is a biomarker for neuromyelitis optica spectrum disease (NMOSD). Co-existence of NMOSD with systemic lupus erythematosus (SLE) putatively suggests susceptibility to antibody-mediated autoimmune disease. Objective: To estimate the prevalence of NMOSD in SLE and investigate the immunogenetic background for an association of NMOSD and SLE. Methods: The study included a predominantly population-based cohort with clinical and serological investigations of 208 patients with SLE, followed prospectively since 1995. All patients received immunosuppressive treatment. NMOSD was evaluated retrospectively based on the 2015 International Panel for NMOSD Diagnosis (IPND) criteria. Polymorphisms in programmed cell death protein 1 (PDCD-1) PD-1.3 G/A were genotyped. AGP4-IgG and other autoantibodies, including myelin oligodendrocyte glycoprotein (MOG), was determined blinded to clinical diagnosis. Results: Of 208 patients with SLE, 45(22{\%}) had neuropsychiatric (NP) SLE, and CNS involvement predominated in 30 of 45 (67{\%}) patients. Serum AQP4-IgG was detected in 2 of 30 (6.7{\%}) neuropsychiatric SLE (NPSLE) patients both of whom had myelitis and antiphospholipid syndrome; one patient also had myasthenia gravis. None had MOG-IgG. PD-1.3A allele was not associated with SLE nor with NPSLE. Conclusion: AQP4-IgG autoimmune syndrome may rarely co-exist with SLE, and such patients have other NMOSD-typical syndromes such as myelitis.",
keywords = "aquaporin-IgG, Epidemiology, myelin oligodendrocyte glycoprotein-IgG, neuromyelitis optica spectrum disease, programmed death 1, systemic lupus erythematosus",
author = "Nasrin Asgari and Sven Jarius and Helle Laustrup and Skejoe, {Hanne P.B.} and Lillevang, {Soeren T.} and Weinshenker, {Brian G} and Anne Voss",
year = "2018",
month = "3",
day = "1",
doi = "10.1177/1352458517699791",
language = "English (US)",
volume = "24",
pages = "331--339",
journal = "Multiple Sclerosis",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "3",

}

TY - JOUR

T1 - Aquaporin-4-autoimmunity in patients with systemic lupus erythematosus

T2 - A predominantly population-based study

AU - Asgari, Nasrin

AU - Jarius, Sven

AU - Laustrup, Helle

AU - Skejoe, Hanne P.B.

AU - Lillevang, Soeren T.

AU - Weinshenker, Brian G

AU - Voss, Anne

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: Serum immunoglobulin G targeting the astrocyte water channel aquaporin-4 (AQP4) in the central nervous system (CNS) is a biomarker for neuromyelitis optica spectrum disease (NMOSD). Co-existence of NMOSD with systemic lupus erythematosus (SLE) putatively suggests susceptibility to antibody-mediated autoimmune disease. Objective: To estimate the prevalence of NMOSD in SLE and investigate the immunogenetic background for an association of NMOSD and SLE. Methods: The study included a predominantly population-based cohort with clinical and serological investigations of 208 patients with SLE, followed prospectively since 1995. All patients received immunosuppressive treatment. NMOSD was evaluated retrospectively based on the 2015 International Panel for NMOSD Diagnosis (IPND) criteria. Polymorphisms in programmed cell death protein 1 (PDCD-1) PD-1.3 G/A were genotyped. AGP4-IgG and other autoantibodies, including myelin oligodendrocyte glycoprotein (MOG), was determined blinded to clinical diagnosis. Results: Of 208 patients with SLE, 45(22%) had neuropsychiatric (NP) SLE, and CNS involvement predominated in 30 of 45 (67%) patients. Serum AQP4-IgG was detected in 2 of 30 (6.7%) neuropsychiatric SLE (NPSLE) patients both of whom had myelitis and antiphospholipid syndrome; one patient also had myasthenia gravis. None had MOG-IgG. PD-1.3A allele was not associated with SLE nor with NPSLE. Conclusion: AQP4-IgG autoimmune syndrome may rarely co-exist with SLE, and such patients have other NMOSD-typical syndromes such as myelitis.

AB - Background: Serum immunoglobulin G targeting the astrocyte water channel aquaporin-4 (AQP4) in the central nervous system (CNS) is a biomarker for neuromyelitis optica spectrum disease (NMOSD). Co-existence of NMOSD with systemic lupus erythematosus (SLE) putatively suggests susceptibility to antibody-mediated autoimmune disease. Objective: To estimate the prevalence of NMOSD in SLE and investigate the immunogenetic background for an association of NMOSD and SLE. Methods: The study included a predominantly population-based cohort with clinical and serological investigations of 208 patients with SLE, followed prospectively since 1995. All patients received immunosuppressive treatment. NMOSD was evaluated retrospectively based on the 2015 International Panel for NMOSD Diagnosis (IPND) criteria. Polymorphisms in programmed cell death protein 1 (PDCD-1) PD-1.3 G/A were genotyped. AGP4-IgG and other autoantibodies, including myelin oligodendrocyte glycoprotein (MOG), was determined blinded to clinical diagnosis. Results: Of 208 patients with SLE, 45(22%) had neuropsychiatric (NP) SLE, and CNS involvement predominated in 30 of 45 (67%) patients. Serum AQP4-IgG was detected in 2 of 30 (6.7%) neuropsychiatric SLE (NPSLE) patients both of whom had myelitis and antiphospholipid syndrome; one patient also had myasthenia gravis. None had MOG-IgG. PD-1.3A allele was not associated with SLE nor with NPSLE. Conclusion: AQP4-IgG autoimmune syndrome may rarely co-exist with SLE, and such patients have other NMOSD-typical syndromes such as myelitis.

KW - aquaporin-IgG

KW - Epidemiology

KW - myelin oligodendrocyte glycoprotein-IgG

KW - neuromyelitis optica spectrum disease

KW - programmed death 1

KW - systemic lupus erythematosus

UR - http://www.scopus.com/inward/record.url?scp=85041606338&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041606338&partnerID=8YFLogxK

U2 - 10.1177/1352458517699791

DO - 10.1177/1352458517699791

M3 - Article

AN - SCOPUS:85041606338

VL - 24

SP - 331

EP - 339

JO - Multiple Sclerosis

JF - Multiple Sclerosis

SN - 1352-4585

IS - 3

ER -