Tumor necrosis factor receptor 2 and anti-ribosomal P antibodies as biomarkers in juvenile neuropsychiatric systemic lupus erythematosus

Neuropsychiatric systemic lupus erythematosus (NPSLE) is more frequent in adolescents than in adults and is indistinguishable from regular mood disorders. To investigate the levels of soluble tumor necrosis factor receptor 2 (sTNFR2) and anti-ribosomal P (anti-rib-p) antibodies in the serum of adolescents suffering from juvenile lupus and their correlation with neuropsychiatric manifestations (NP) and disease activity. Sixty adolescents diagnosed with systemic lupus erythematosus (SLE) visiting Ain Shams University hospitals were assessed for NPSLE. Subjects were divided into 3 groups. Group 1 comprised 30 patients suffering from NP manifestations, while group 2 included 30 patients without NP manifestations. Computerized Axial Tomography (CAT) scans of the brain were done for NPSLE patients to exclude organic disease. Group 3 comprised 30 age and gender-matched healthy adolescents. Lupus activity was evaluated by the Systemic Lupus Disease Activity Index (SLEDAI). Levels of sTNFR2 and anti-rib-P antibodies were analyzed using enzyme-linked immunosorbent assay (ELISA). The levels of sTNFR2 and anti-rib-P antibodies were significantly higher (P < 0.0001) in lupus patients compared to healthy subjects. Anti-rib-P antibodies levels were significantly higher in patients with NPSLE compared to those without NPSLE. Levels of sTNFR2 correlated positively with SLEDAI and ESR. Similar correlations were observed for anti-rib-P antibodies. The study showed that anti-rib-P antibodies could be used as biomarkers for the early diagnosis of NPSLE and sTNFR2 could be a valuable marker for the evaluation of juvenile lupus activity.