PIO led team identifies potential biomarkers for neurological symptoms of lupus

Houston: A team led by an Indian-origin scientist in the US has identified potential biomarkers for neurological symptoms of lupus, which can help physicians diagnose the autoimmune disease more accurately, and provide better treatment options.

In lupus, the immune system attacks its own tissues, causing widespread inflammation and tissue damage in various organs including the kidneys, brain and heart.

Neuropsychiatric lupus (NPSLE) can cause lupus patients to be afflicted with a variety of neurological issues ranging from headaches, depression and seizures.

”This recent work focuses on neurological lupus. Patients with lupus often develop neurological symptoms, but it is very challenging for physicians to determine if the symptoms are truly due to lupus, or to other less worrisome causes,” Chandra Mohan, Hugh Roy and Lillie Cranz Cullen Endowed Professor of biomedical engineering at University of Houston, told PTI.

”The new report has uncovered a couple of proteins in the spinal fluid that can help physicians diagnose this disease more accurately so that correct treatment can be commenced sooner,” Mohan said.

Mohan’s team screened more than 1,100 proteins in the fluid surrounding the brains of neuropsychiatric lupus patients and identified a few proteins that could potentially be used to diagnose neuropsychiatric lupus.

The research, published in the journal Arthritis & Rheumatology, found that proteins that showed up in most samples were cerebrospinal fluid (CSF) Lipocalin-2, M-CSF, IgM and complement C3.

”These proteins emerged as promising cerebrospinal fluid biomarkers of NPSLE with diagnostic potential,” Mohan said.

”Elevated CSF C3 was associated with acute confusional state. Eleven molecules elevated in the fluid exhibited concordant elevation in the choroid plexus, suggesting shared origins,” he explained.

Choroid plexus is a network of blood vessels in the brain which produce the cerebrospinal fluid.

”The diagnosis of neuropsychiatric lupus is difficult because the neurological symptoms could very well be due to other causes, as no diagnostic test exists for NPSLE, we executed a broad screen of NPSLE cerebrospinal fluid using an aptamer-based platform,” Mohan said.

Aptamers are short sequences of nucleic acids that can be further selected based on their binding specificities.

Commercially available libraries of aptamers allow comprehensive screening of more than 1,000 human protein targets, representing some of the largest screening platforms currently available.

Neuropsychiatric events occur most frequently early during the disease course in most cases, either as a presenting symptom or within the first five years of disease onset.

Cerebrospinal fluid samples used in the study were provided by collaborators John Hanly from Dalhousie Lupus Clinic, Canada and C.C. Mok from Tuen Mun hospital in Hong Kong.

Laboratory studies were carried out by University of Houston researcher Kamala Vanarsa in Mohan’s lab.

”We believe proteomic investigations of blood and cerebrospinal fluid will eventually lead to the fabrication of a serum or cerebrospinal fluid-based diagnostic panel that permits accurate diagnosis of NPSLE, with significantly higher specificity for this disease, compared to other neuroinflammatory diseases or infections,” Mohan said.

While most people with lupus experience a variety of symptoms that include fatigue, skin rashes, fever, and pain or swelling in the joints, about half of people with lupus suffer neuropsychiatric symptoms.

Those include seizures, aseptic meningitis, acutely confused states, cerebrovascular disease psychosis and mood disorders.