Unveiling the Link Between Antiphospholipid Antibodies and Cognitive Dysfunction in the Begore Almenara Lupus Cohort.
Journal
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
ISSN: 1536-7355
Titre abrégé: J Clin Rheumatol
Pays: United States
ID NLM: 9518034
Informations de publication
Date de publication:
20 Dec 2023
20 Dec 2023
Historique:
medline:
20
12
2023
pubmed:
20
12
2023
entrez:
20
12
2023
Statut:
aheadofprint
Résumé
Cognitive dysfunction is a prevalent manifestation of systemic lupus erythematosus (SLE). There is evidence for the role of antiphospholipid (aPL) antibodies on its etiopathogenesis. Our objective was to identify the association between aPL antibodies and cognitive dysfunction in SLE patients. This cross-sectional study included 135 patients evaluated from March 2015 to October 2017 at one center. Cognitive deficit was measured using the NEUROPSI test. Disease activity and damage were ascertained using the SLEDAI-2K (SLE Disease Activity Index 2000) and the SDI (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), respectively; aPL antibodies were measured by enzyme-linked immunosorbent assay. The association between cognitive dysfunction and aPL antibodies was evaluated using univariable and multivariable linear regression models adjusted for age, sex, education, socioeconomic status, disease duration, SLEDAI-2K, SDI, mean current dose of prednisone, time of exposure to glucocorticoids, and drug use (immunosuppressants, hydroxychloroquine, aspirin, and warfarin). One hundred thirty-one patients (97.1%) were women; their mean (SD) age was 46.6 (12.5) years; 59 patients (43.7%) had positivity for at least 1 aPL antibody. IgM anticardiolipin (aCL) was positive in 24.5%, IgG in 13.5%, IgM aβ2GP1 in 16.8%, IgG anti-β2 glycoprotein in 24.6%, and the lupus anticoagulant in 5.3%. Ninety patients (66.7%) had some cognitive dysfunction. In the univariable analysis, a significant correlation between the NEUROPSI score and IgM aCL antibodies was found (B = -20.87 [SE, 3.2]; p < 0.001), which remained significant in the multivariable model (B = -13.89 [SE, 3.14]; p < 0.001). IgM aCL antibodies are associated with cognitive dysfunction in patients with SLE. Larger and longitudinal studies are needed to assess the impact of these findings.
Identifiants
pubmed: 38115180
doi: 10.1097/RHU.0000000000002049
pii: 00124743-990000000-00175
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
M.F.U.-G. has grant support from Janssen and Pfizer, and he has been speaker for GSK and consultant for AstraZeneca; R.V.G.-C. has grant support from Pfizer; C.R.-S. and V.P.-Q. have grant support from Janssen. All other authors declare to have no conflicts of interest.
Références
Schwartz N, Stock AD, Putterman C. Neuropsychiatric lupus: new mechanistic insights and future treatment directions. Nat Rev Rheumatol. 2019;15:137–152.
Jönsen A, Bengtsson AA, Nived O, et al. Outcome of neuropsychiatric systemic lupus erythematosus within a defined Swedish population: increased morbidity but low mortality. Rheumatology (Oxford). 2002;41:1308–1312.
Tam L-S, Wong A, Mok VC, et al. The relationship between neuropsychiatric, clinical, and laboratory variables and quality of life of Chinese patients with systemic lupus erythematosus. J Rheumatol. 2008;35:1038–1045.
Appenzeller S, Lapa AT, Guirau CR, et al. Cognitive impairment in antiphospholipid syndrome: evidence from animal models. J Clin Rheumatol. 2012;31:403–406.
Bucci T, Menichelli D, Pignatelli P, et al. Relationship of antiphospholipid antibodies to risk of dementia: a systematic review. J Alzheimer's Dis. 2019;69:561–576.
Gerosa M, Poletti B, Pregnolato F, et al. Antiglutamate receptor antibodies and cognitive impairment in primary antiphospholipid syndrome and systemic lupus erythematosus. Front Immunol. 2016;7:5.
Méndez Castellano H, De Méndez MC. Sociedad y Estratificación: Método Graffar-Méndez Castellano. Sociedad y Estratificación: Metodo Graffar-Mendez Castellano. Fundacredesa. 1994;206–208.
Vega-Dienstmaier JM, Coronado-Molina O, Mazzotti G. Validez de una versión en Español del Inventario de Depresión de Beck en pacientes hospitalizados de medicina general. Rev Neuropsiquiatr. 2014;77:95–103.
Marreros-Tananta J, Guerrero-Alcedo JM. Propiedades Psicométricas Del Test De Evaluación Neuropsicológica-Neuropsi En Población Peruana. Rev Ecuat Neurol. 2022;31:40–48.
Querejeta AN, Sarquís YF, Moreno MA, et al. Test Neuropsi: normas según edad y nivel de instrucción para Argentina. Cuad Neuropsicol. 2012;6:48–58.
Ostrosky-Solís F, Esther Gómez-Pérez M, Matute E, et al. Neuropsi attention and memory: a neuropsychological test battery in Spanish with norms by age and educational level. Appl Neuropsychol. 2007;14:156–170.
Alcocer-Castillejos N, Jiménez-González A, Hinojosa-Azaola AJ. No difference in cognitive dysfunction among patients with ANCA-associated vasculitis, rheumatoid arthritis or chronic kidney disease. J Int Neuropsychol Soc. 2019;25:595–602.
Ostrosky-Solís F, Ardila A, Rosselli MJ. NEUROPSI: a brief neuropsychological test battery in Spanish with norms by age and educational level. J Int Neuropsychol Soc. 1999;5:413–433.
Taraborelli M, Leuenberger L, Lazzaroni MG, et al. The contribution of antiphospholipid antibodies to organ damage in systemic lupus erythematosus. Lupus. 2016;25:1365–1368.
Marchetti T, Ribi C, Perneger T, et al. Prevalence, persistence and clinical correlations of classic and novel antiphospholipid antibodies in systemic lupus erythematosus. Rheumatology. 2018;57:1350–1357.
González LA, Toloza SM, Alarcón GS. Impact of race and ethnicity in the course and outcome of systemic lupus erythematosus. Rheum Dis Clin North Am. 2014;40, :–54.
Urrego-Callejas T, Hernández A, Giraldo SR, et al. Importancia de los títulos de anticuerpos antifosfolípidos no criterio entre pacientes con síndrome antifosfolípido primario y pacientes con lupus eritematoso sistémico. Reumatol Clin. 2022;19:197–203.
D'Amico M, Romero J, Rodriguez G, et al. Estudio multicéntrico de deterioro cognitivo en lupus eritematoso sistémico: ECLES. Rev Arg Reumatol. 2015;26:28–32.
Fernandez H, Cevallos A, Jimbo Sotomayor R, et al. Mental disorders in systemic lupus erythematosus: a cohort study. Rheumatol Int. 2019;39:1689–1695.
Kanapathy A, Nik Jaafar NR, Shaharir SS, et al. Prevalence of cognitive impairment using the Montreal cognitive assessment questionnaire among patients with systemic lupus erythematosus: a cross-sectional study at two tertiary centres in Malaysia. Lupus. 2019;28:854–861.
Chapman J, Cohen-Armon M, Shoenfeld Y, et al. Antiphospholipid antibodies permeabilize and depolarize brain synaptoneurosomes. Lupus. 1999;8:127–133.
Erkan D, Barbhaiya M, George D, et al. Moderate versus high-titer persistently anticardiolipin antibody positive patients: are they clinically different and does high-titer anti-β2-glycoprotein-I antibody positivity offer additional predictive information? Lupus. 2010;19:613–619.
Murray SG, Yazdany J, Kaiser R, et al. Cardiovascular disease and cognitive dysfunction in systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2012;64:1328–1333.
Raghunath S, Glikmann-Johnston Y, Golder V, et al. Clinical associations of cognitive dysfunction in systemic lupus erythematosus. Lupus Sci Med. 2023;10:e000835.
Shoenfeld Y, Nahum A, Korczyn AD, et al. Neuronal-binding antibodies from patients with antiphospholipid syndrome induce cognitive deficits following intrathecal passive transfer. Lupus. 2003;12:436–442.
Ceccarelli F, Perricone C, Pirone C, et al. Cognitive dysfunction improves in systemic lupus erythematosus: results of a 10 years prospective study. PloS One. 2018;13:e0196103.
McLaurin EY, Holliday SL, Williams P, et al. Predictors of cognitive dysfunction in patients with systemic lupus erythematosus. Neurology. 2005;64:297–303.
Appelhans BM. The cognitive burden of poverty: a mechanism of socioeconomic health disparities. Am J Prev Med. 2023;64:293–297.