- PROJECT 2 Reported prevalence of cognitive impairment in SLE ranges from 30-80% and behavioral alterations range from 17-75% with significant effects on quality of life and individual productivity. A hypothesis of this Program Grant is that autoantibodies cross-reactive with dsDNA and NMDA receptors, DNRAbs, contribute to cognitive and behavioral impairment in SLE patients. The goals of Project 2 are to continue development of FDG-PET as a biomarker for cognitive and behavioral impairment in NPSLE and to utilize other novel imaging techniques to enhance our understanding of pathologic mechanisms related to DNRAb effects on the brain. Cross-sectional FDG-PET studies of resting brain glucose metabolism demonstrate abnormal hypermetabolism in the hippocampus of SLE subjects. Hippocampus hypermetabolism and elevated serum titers of DNRAb combined have a higher predictive value for memory impairment than either variable alone. This is the first example of a consistent and robust imaging finding that reflects both impaired functional status and a proposed pathogenic mechanism in NPSLE. The longitudinal study proposed in Project 2 will validate and extend these associations. Subjects in the SLE cohort will be selected to have a range of serum DNRAb titers that is equally distributed across a spectrum of normal to high titers. The proposed longitudinal study will inform us about correlates of cognitive and behavioral change over time using FDG-PET imaging (Aim 1). Additionally, we will explore NMDAR biology in human subjects with a novel PET ligand, [11C]-CNS5161, used to localize and quantify NMDAR activation (Aim 2) and explore the role of blood brain barrier (BBB) integrity in cognitive and behavioral impairment (Aim 3). These studies complement the studies proposed in Project 1 that will explore the molecular and cellular basis for the hippocampal hypermetabolism in mouse models where tissue is readily available. In conducting these longitudinal studies, we will also determine the best biomarker with sensitivity for disease progression that can be used as a metric for a clinical trial.
- PROJECT 2 Cognitive and behavioral impairment is present in many, if not most, patients with lupus. Animal studies have elegantly demonstrated the toxic effects of certain autoantibodies on neurons in the brain resulting in cognitive and behavioral abnormalities, however, clear correlations have been lacking in human studies. The proposed studies have the potential to inform us about autoantibody-mediated immune mechanisms that contribute to cognitive and behavioral impairment in human SLE. Improvement in cognition in SLE patients can result in improved quality of life and increased productivity that would benefit society as a whole.
|Mader, Simone; Brimberg, Lior; Soltys, John N et al. (2018) Mutations of Recombinant Aquaporin-4 Antibody in the Fc Domain Can Impair Complement-Dependent Cellular Cytotoxicity and Transplacental Transport. Front Immunol 9:1599|
|Suurmond, Jolien; Atisha-Fregoso, Yemil; Marasco, Emiliano et al. (2018) Loss of an IgG plasma cell checkpoint in patients with lupus. J Allergy Clin Immunol :|
|Nestor, Jacquelyn; Arinuma, Yoshiyuki; Huerta, Tomás S et al. (2018) Lupus antibodies induce behavioral changes mediated by microglia and blocked by ACE inhibitors. J Exp Med 215:2554-2566|
|Kim, Sook Young; Son, Myoungsun; Lee, Sang Eun et al. (2018) High-Mobility Group Box 1-Induced Complement Activation Causes Sterile Inflammation. Front Immunol 9:705|
|Malkiel, Susan; Barlev, Ashley N; Atisha-Fregoso, Yemil et al. (2018) Plasma Cell Differentiation Pathways in Systemic Lupus Erythematosus. Front Immunol 9:427|
|VanPatten, Sonya; Sun, Shan; He, Mingzhu et al. (2016) Amending HIV Drugs: A Novel Small-Molecule Approach To Target Lupus Anti-DNA Antibodies. J Med Chem 59:8859-8867|
|Vingtdeux, Valérie; Chang, Eric H; Frattini, Stephen A et al. (2016) CALHM1 deficiency impairs cerebral neuron activity and memory flexibility in mice. Sci Rep 6:24250|
|Brimberg, L; Mader, S; Jeganathan, V et al. (2016) Caspr2-reactive antibody cloned from a mother of an ASD child mediates an ASD-like phenotype in mice. Mol Psychiatry 21:1663-1671|
|Honig, Gerard; Mader, Simone; Chen, Huiyi et al. (2016) Blood-Brain Barrier Deterioration and Hippocampal Gene Expression in Polymicrobial Sepsis: An Evaluation of Endothelial MyD88 and the Vagus Nerve. PLoS One 11:e0144215|
|Malkiel, Susan; Jeganathan, Venkatesh; Wolfson, Stacey et al. (2016) Checkpoints for Autoreactive B Cells in the Peripheral Blood of Lupus Patients Assessed by Flow Cytometry. Arthritis Rheumatol 68:2210-20|
Showing the most recent 10 out of 37 publications