Review: Nervous System Disease in Systemic Lupus Erythematosus: Current Status and Future Directions

John G. Hanly; Elizabeth Kozora; Steven D. Beyea; Julius Birnbaum

doi:10.1002/art.40591

Review: Nervous System Disease in Systemic Lupus Erythematosus: Current Status and Future Directions

John G. Hanly, Elizabeth Kozora, Steven D. Beyea, Julius Birnbaum

School of Medicine

Research output: Contribution to journal › Review article › peer-review

31 Scopus citations

Abstract

The American College of Rheumatology's case definitions for 19 neuropsychiatric syndromes in systemic lupus erythematosus (SLE) constitute a comprehensive classification of nervous system events in this disease. However, additional strategies are needed to determine whether a neuropsychiatric syndrome is attributable to SLE versus a competing comorbidity. Cognitive function is a clinical surrogate of overall brain health, with applications in both diagnosis and determination of clinical outcomes. Ischemic and inflammatory mechanisms are both key components of the immunopathogenesis of neuropsychiatric SLE (NPSLE), including abnormalities of the blood–brain barrier and autoantibody-mediated production of proinflammatory cytokines. Advances in neuroimaging provide a platform to assess novel disease mechanisms in a noninvasive way. The convergence of more rigorous clinical characterization, validation of biomarkers, and brain neuroimaging provides opportunities to determine the efficacy of novel targeted therapies in the treatment of NPSLE.

Original language	English (US)
Pages (from-to)	33-42
Number of pages	10
Journal	Arthritis and Rheumatology
Volume	71
Issue number	1
DOIs	https://doi.org/10.1002/art.40591
State	Published - Jan 2019

ASJC Scopus subject areas

Immunology and Allergy
Rheumatology
Immunology

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title = "Review: Nervous System Disease in Systemic Lupus Erythematosus: Current Status and Future Directions",

abstract = "The American College of Rheumatology's case definitions for 19 neuropsychiatric syndromes in systemic lupus erythematosus (SLE) constitute a comprehensive classification of nervous system events in this disease. However, additional strategies are needed to determine whether a neuropsychiatric syndrome is attributable to SLE versus a competing comorbidity. Cognitive function is a clinical surrogate of overall brain health, with applications in both diagnosis and determination of clinical outcomes. Ischemic and inflammatory mechanisms are both key components of the immunopathogenesis of neuropsychiatric SLE (NPSLE), including abnormalities of the blood–brain barrier and autoantibody-mediated production of proinflammatory cytokines. Advances in neuroimaging provide a platform to assess novel disease mechanisms in a noninvasive way. The convergence of more rigorous clinical characterization, validation of biomarkers, and brain neuroimaging provides opportunities to determine the efficacy of novel targeted therapies in the treatment of NPSLE.",

author = "Hanly, {John G.} and Elizabeth Kozora and Beyea, {Steven D.} and Julius Birnbaum",

note = "Funding Information: Dr. Hanly{\textquoteright}s work is supported the Canadian Institutes of Health Research (grant MOP-88526). Dr. Beyea{\textquoteright}s work is supported by a grant from Brain Canada (grant PSG 2015-3780). Dr. Birnbaum{\textquoteright}s work is supported by the NIH (grant K23-AR-064279). Publisher Copyright: {\textcopyright} 2018, American College of Rheumatology",

year = "2019",

month = jan,

doi = "10.1002/art.40591",

language = "English (US)",

volume = "71",

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AU - Birnbaum, Julius

N1 - Funding Information: Dr. Hanly’s work is supported the Canadian Institutes of Health Research (grant MOP-88526). Dr. Beyea’s work is supported by a grant from Brain Canada (grant PSG 2015-3780). Dr. Birnbaum’s work is supported by the NIH (grant K23-AR-064279). Publisher Copyright: © 2018, American College of Rheumatology

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N2 - The American College of Rheumatology's case definitions for 19 neuropsychiatric syndromes in systemic lupus erythematosus (SLE) constitute a comprehensive classification of nervous system events in this disease. However, additional strategies are needed to determine whether a neuropsychiatric syndrome is attributable to SLE versus a competing comorbidity. Cognitive function is a clinical surrogate of overall brain health, with applications in both diagnosis and determination of clinical outcomes. Ischemic and inflammatory mechanisms are both key components of the immunopathogenesis of neuropsychiatric SLE (NPSLE), including abnormalities of the blood–brain barrier and autoantibody-mediated production of proinflammatory cytokines. Advances in neuroimaging provide a platform to assess novel disease mechanisms in a noninvasive way. The convergence of more rigorous clinical characterization, validation of biomarkers, and brain neuroimaging provides opportunities to determine the efficacy of novel targeted therapies in the treatment of NPSLE.

AB - The American College of Rheumatology's case definitions for 19 neuropsychiatric syndromes in systemic lupus erythematosus (SLE) constitute a comprehensive classification of nervous system events in this disease. However, additional strategies are needed to determine whether a neuropsychiatric syndrome is attributable to SLE versus a competing comorbidity. Cognitive function is a clinical surrogate of overall brain health, with applications in both diagnosis and determination of clinical outcomes. Ischemic and inflammatory mechanisms are both key components of the immunopathogenesis of neuropsychiatric SLE (NPSLE), including abnormalities of the blood–brain barrier and autoantibody-mediated production of proinflammatory cytokines. Advances in neuroimaging provide a platform to assess novel disease mechanisms in a noninvasive way. The convergence of more rigorous clinical characterization, validation of biomarkers, and brain neuroimaging provides opportunities to determine the efficacy of novel targeted therapies in the treatment of NPSLE.

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Review: Nervous System Disease in Systemic Lupus Erythematosus: Current Status and Future Directions

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ASJC Scopus subject areas

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