Lm. Silva et Ea. Donadi, IS IMMUNOGENETIC SUSCEPTIBILITY TO NEUROPSYCHIATRIC SYSTEMIC LUPUS-ERYTHEMATOSUS (SLE) DIFFERENT FROM NON-NEUROPSYCHIATRIC SLE, Annals of the Rheumatic Diseases, 55(8), 1996, pp. 544-547
Objectives-To analyse frequency of HLA class II antigens (DR and DQ) a
nd lymphocytotoxic autoantibodies in patients with systemic lupus eryt
hematosus (SLE) and subsets with or without neuropsychiatric involveme
nt. Methods-Ninety three patients with SLE (42 with neuropsychiatric f
eatures) were typed for HLA class II antigens and investigated for the
presence of lymphocytotoxic autoantibodies by a complement dependent
microlymphocytotoxicity assay. A total of 191 controls of similar ethn
ic background were also typed for HLA antigens. Results-HLA-DR3 antige
n was increased in the total group of patients with SLE (p=0.003) and
in the neuropsychiatric group (p=0.002). HLA-DR4 antigen frequency was
increased in non-neuropsychiatric patients (p=0.001) and decreased in
patients with neuropsychiatric SLE (p = 0.0005). Comparisons of HLA f
requencies between subgroups of patients showed decreased HLA-DR4 (p<0
.0001) and increased HLA-DR9 and HLA-DQ2 antigens (p = 0.0008 and 0.00
5 respectively) in the neuropsychiatric group. The frequency of lympho
cytotoxic autoantibodies was increased in neuropsychiatric patients wi
th SLE having HLA-DR9 specificity (p = 0.04). Conclusion-HLA-DR4 may h
ave a protective specificity for the development of neuropsychiatric f
eatures of SLE and HLA-DR9, in addition to HLA-DR3, and the presence o
f lymphocytotoxic autoantibodies may predispose to neuropsychiatric ab
normalities.