Abstract
We present a succinct review of our approach to study the interactions between the DNA-reactive antibodies that cross-react with the GluN2A and GluN2B subunits of the N-methyl-d-aspartate receptor, denoted DNRABs, and their brain targets in subjects with neuropsychiatric systemic lupus erythematosus (NPSLE). We have analyzed the DNRAB-based brain symptomatology in mouse models of NPSLE by using an integrative neuroscience approach, which includes behavioral assessment coupled with electrophysiological studies of neural networks and synaptic connections in target brain regions, such as the CA1 region of the hippocampus. Our results suggest a framework for understanding the interactions between immune factors and neural networks.
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References
Danchenko N, Satia J, Anthony M. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus. 2006;15:308–18.
Lahita RG. Systemic lupus erythematosus. 4th ed. Amsterdam: Elsevier; 2004.
ACR Ad Hoc Committee on Neuropsychiatric Lupus Nomenclature. The American College of Rheumatology. Nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42:599–608.
Brey RL, et al. Neuropsychiatric syndromes in lupus: prevalence using standardized definitions. Neurology. 2002;58:1214–20.
Bertsias GK, Boumpas DT. Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations. Nat Rev Rheumatol. 2010;6:358–67.
Ainiala H, et al. The prevalence of neuropsychiatric syndromes in systemic lupus erythematosus. Neurology. 2001;57:496–500.
Levy D, Ardoin S, Schanberg L. Neurocognitive impairment in children and adolescents with systemic lupus erythematosus. Nat Clin Pract Rheumatol. 2009;5:106–14.
Hanly JG. Neuropsychiatric lupus. Rheum Dis Clin North Am. 2005;31:273–98.
Hanly JG, et al. Prospective analysis of neuropsychiatric events in an international disease inception cohort of patients with systemic lupus erythematosus. Ann Rheum Dis. 2010;69:529–35.
Sabbadini M, et al. (1999). Central nervous system involvement in systemic lupus erythematosus patients without overt neuropsychiatric manifestations. Lupus 8:11–9.
Hanly JG, et al. A prospective analysis of cognitive function and anticardiolipin antibodies in systemic lupus erythematosus. Arthritis Rheum. 1999;42:728–34.
Carbotte RM, Denburg SD, Denburg JA. Prevalence of cognitive impairment in systemic lupus erythematosus. J Nerv Ment Dis. 1986;174:357–64.
Denburg SD, Carbotte RM, Denburg JA. Cognitive impairment in systemic lupus erythematosus: a neuropsychological study of individual and group deficits. J Clin Exp Neuropsychol. 1987;9:323–39.
Hanly JG, Robichaud J, Fisk J. Anti-NR2 glutamate receptor antibodies and cognitive function in systemic lupus erythematosus. J Rheumatol. 2006;33:1553–8.
Hanly JG. Diagnosis and management of neuropsychiatric SLE. Nat Rev Rheumatol. 2014;10:338–47.
Jeltsch-David H, Muller S. Neuropsychiatric systemic lupus erythematosus: pathogenesis and biomarkers. Nat Rev Neurol. 2014;10:579–96.
Olazarán J, et al. Cognitive dysfunction in systemic lupus erythematosus: prevalence and correlates. Eur Neurol. 2009;62:49–55.
Kozora E, et al. Inflammatory and hormonal measures predict neuropsychological functioning in systemic lupus erythematosus and rheumatoid arthritis patients. J Int Neuropsychol Soc. 2001;7:745–54.
Wallace DJ, Hahn B, Dubois EL. Dubois’ lupus erythematosus. 5th ed. Baltimore: Williams & Wilkins; 1997.
Carbotte RM, Denburg SD, Denburg JA. Cognitive dysfunction in systemic lupus erythematosus is independent of active disease. J Rheumatol. 1995;22:863–7.
McLaurin EY, et al. Predictors of cognitive dysfunction in patients with systemic lupus erythematosus. Neurology. 2005;64:297–303.
Harboe E, et al. Neuropsychiatric syndromes in patients with systemic lupus erythematosus and primary Sjögren syndrome: a comparative population-based study. Ann Rheum Dis. 2009;68:1541–6.
Utset TO, et al. Prevalence of neurocognitive dysfunction and other clinical manifestations in disabled patients with systemic lupus erythematosus. J Rheumatol. 2006;33:531–8.
Appenzeller S, et al. Cognitive impairment and employment status in systemic lupus erythematosus: a prospective longitudinal study. Arthritis Rheum. 2009;61:680–7.
Roebuck-Spencer TM, et al. Use of computerized assessment to predict neuropsychological functioning and emotional distress in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;55:434–41.
Kozora E, et al. Cognitive dysfunction in systemic lupus erythematosus: past, present, and future. Arthritis Rheum. 2008;58:3286–98.
Petri M, et al. Cognitive function in a systemic lupus erythematosus inception cohort. J Rheumatol. 2008;35:1776–81.
Bertsias GK, et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010;69:2074–82.
Brunner HI, et al. Initial validation of the Pediatric Automated Neuropsychological Assessment Metrics for childhood-onset systemic lupus erythematosus. Arthritis Rheum. 2007;57:1174–82.
Cieślik P, et al. Vasculopathy and vasculitis in systemic lupus erythematosus. Pol Arch Med Wewn. 2008;118:57–63.
Fietta P, et al. Psychiatric and neuropsychological manifestations of systemic lupus erythematosus. Acta Biomed. 2011;82:97–114.
Golan TD. Lupus vasculitis: differential diagnosis with antiphospholipid syndrome. Curr Rheumatol Rep. 2002;4:18–24.
Bluestein HG, Zvaifler NJ. Brain-reactive lymphocytotoxic antibodies in the serum of patients with systemic lupus erythematosus. J Clin Invest. 1976;57:509–16.
Bresnihan B, et al. Brain reactivity of lymphocytotoxic antibodies in systemic lupus erythematosus with and without cerebral involvement. Clin Exp Immunol. 1977;30:333–7.
Bresnihan B, et al. An antineuronal antibody cross-reacting with erythrocytes and lymphocytes in systemic lupus erythematosus. Arthritis Rheum. 1979;22:313–20.
How A, et al. Antineuronal antibodies in neuropsychiatric systemic lupus erythematosus. Arthritis Rheum. 1985;28:789–95.
Temesvari P, et al. Serum lymphocytotoxic antibodies in neuropsychiatric lupus: a serial study. Clin Immunol Immunopathol. 1983;28:243–51.
Wilson HA, et al. Association of IgG anti-brain antibodies with central nervous system dysfunction in systemic lupus erythematosus. Arthritis Rheum. 1979;22:458–62.
DeGiorgio LA, et al. A subset of lupus anti-DNA antibodies cross-reacts with the NR2 glutamate receptor in systemic lupus erythematosus. Nat Med. 2001;7:1189–93.
Kowal C, et al. Cognition and immunity; antibody impairs memory. Immunity. 2004;21:179–88.
Huerta PT, et al. Immunity and behavior: antibodies alter emotion. Proc Natl Acad Sci USA. 2006;103:678–83.
Kowal C, et al. Human lupus autoantibodies against NMDA receptors mediate cognitive impairment. Proc Natl Acad Sci USA. 2006;103:19854–9.
Lee JY, et al. Neurotoxic autoantibodies mediate congenital cortical impairment of offspring in maternal lupus. Nat Med. 2009;15:91–6.
Diamond B, et al. Losing your nerves? Maybe it’s the antibodies. Nat Rev Immunol. 2009;9:449–56.
Faust TW, et al. Neurotoxic lupus autoantibodies alter brain function through two distinct mechanisms. Proc Natl Acad Sci USA. 2010;107:18569–74.
Wang L, et al. Female mouse fetal loss mediated by maternal autoantibody. J Exp Med. 2012;209:1083–9.
Bloom O, et al. Generation of a unique small peptidomimetic that neutralizes lupus autoantibody activity. Proc Natl Acad Sci USA. 2011;108:10255–9.
Diamond B, et al. Moving towards a cure: blocking pathogenic antibodies in systemic lupus erythematosus. J Intern Med. 2011;269:36–44.
Mackay M, et al. Differences in regional brain activation patterns assessed by functional magnetic resonance imaging in patients with systemic lupus erythematosus stratified by disease duration. Mol Med. 2011;17:1349–56.
Fragoso-Loyo H, et al. Serum and cerebrospinal fluid autoantibodies in patients with neuropsychiatric lupus erythematosus. Implications for diagnosis and pathogenesis. PLoS ONE. 2008;3:e3347.
Yoshio T, et al. Association of IgG anti-NR2 glutamate receptor antibodies in cerebrospinal fluid with neuropsychiatric systemic lupus erythematosus. Arthritis Rheum. 2006;54:675–8.
Steup-Beekman G, et al. Anti-NMDA receptor autoantibodies in patients with systemic lupus erythematosus and their first-degree relatives. Lupus. 2007;16:329–34.
Arinuma Y, et al. Association of cerebrospinal fluid anti-NR2 glutamate receptor antibodies with diffuse neuropsychiatric systemic lupus erythematosus. Arthritis Rheum. 2008;58:1130–5.
Bosch X, et al. The DWEYS peptide in systemic lupus erythematosus. Trends Mol Med. 2012;18:215–23.
Lauvsnes MB, Omdal R. Systemic lupus erythematosus, the brain, and anti-NR2 antibodies. J Neurol. 2012;259:622–9.
Matus S, et al. Antiribosomal-P autoantibodies from psychiatric lupus target a novel neuronal surface protein causing calcium influx and apoptosis. J Exp Med. 2007;204:3221–34.
Kivity S, et al. Abnormal olfactory function demonstrated by manganese-enhanced MRI in mice with experimental neuropsychiatric lupus. Ann N Y Acad Sci. 2010;1193:70–7.
Jacob A, et al. C5a alters blood-brain barrier integrity in experimental lupus. FASEB J. 2010;24:1682–8.
Sakić B. The MRL model: an invaluable tool in studies of autoimmunity-brain interactions. Methods Mol Biol. 2012;934:277–99.
Gielen M, et al. Mechanism of differential control of NMDA receptor activity by NR2 subunits. Nature. 2009;459:703–7.
Collingridge GL, Kehl SJ, McLennan H. Excitatory amino acids in synaptic transmission in the Schaffer collateral-commissural pathway of the rat hippocampus. J Physiol. 1983;334:33–46.
Ozawa S, Kamiya H, Tsuzuki K. Glutamate receptors in the mammalian central nervous system. Prog Neurobiol. 1998;54:581–618.
Huntley GW, Vickers JC, Morrison JH. Cellular and synaptic localization of NMDA and non-NMDA receptor subunits in neocortex: organizational features related to cortical circuitry, function and disease. Trends Neurosci. 1994;17:536–43.
Wenthold RJ, et al. Evidence for multiple AMPA receptor complexes in hippocampal CA1/CA2 neurons. J Neurosci. 1996;16:1982–9.
Regalado MP, Villarroel A, Lerma J. Intersubunit cooperativity in the NMDA receptor. Neuron. 2001;32:1085–96.
Kutsuwada T, et al. Molecular diversity of the NMDA receptor channel. Nature. 1992;358:36–41.
Collingridge GL, Singer W. Excitatory amino acid receptors and synaptic plasticity. Trends Pharmacol Sci. 1990;11:290–6.
Coan EJ, Collingridge GL. Magnesium ions block an N-methyl-D-aspartate receptor-mediated component of synaptic transmission in rat hippocampus. Neurosci Lett. 1985;53:21–6.
Aarts M, et al. Treatment of ischemic brain damage by perturbing NMDA receptor- PSD-95 protein interactions. Science. 2002;298:846–50.
Aarts M, Tymianski M. Molecular mechanisms underlying specificity of excitotoxic signaling in neurons. Curr Mol Med. 2004;4:137–47.
Hong SJ, Dawson TM, Dawson VL. Nuclear and mitochondrial conversations in cell death: PARP-1 and AIF signaling. Trends Pharmacol Sci. 2004;25:259–64.
Cull-Candy SG, Leszkiewicz DN. Role of distinct NMDA receptor subtypes at central synapses. Science. 2004;255:16–25.
Cajal SR. Histologie du systeme nerveux de l’homme et des vertebrae. Paris: Moline; 1911.
Amaral DG, Witter MP. Hippocampal formation. In: Paxinos G, editor. The rat nervous system. New York: Academic Press; 1995. p. 443–93.
Scoville WB, Milner B. Loss of recent memory after bilateral hippocampal lesions. J Neurochem. 1957;20:11–21.
Mishkin M, Vargha-Khadem F, Gadian DG. Amnesia and the organization of the hippocampal system. Hippocampus. 1998;8:212–6.
Morris RGM. Theories of hippocampal function. In: Andersen P, Morris RM, Amaral D, Bliss T, O’Keefe J, editors. The Hippocampus Book. New York: Oxford University Press; 2007. p. 581–714.
O’Keefe J, Nadel L. The hippocampus as a cognitive map. New York: Oxford University Press; 1978.
O’Keefe J. Hippocampal neurophysiology in the behaving animal. In: Morris RM, Amaral D, Bliss T, O’Keefe J, editors. The Hippocampus Book Andersen P. New York: Oxford University Press; 2007. p. 475–548.
Morris RG, et al. Place navigation impaired in rats with hippocampal lesions. Nature. 1982;297:681–3.
Morris RG, et al. Selective impairment of learning and blockade of long-term potentiation by an N-methyl-D-aspartate receptor antagonist, AP5. Nature. 1986;319:774–6.
McEchron MD, et al. Hippocampectomy disrupts auditory trace fear conditioning and contextual fear conditioning in the rat. Hippocampus. 1998;8:638–46.
Tsien JZ, Huerta PT, Tonegawa S. The essential role of hippocampal CA1 NMDA receptor-dependent synaptic plasticity in spatial memory. Cell. 1996;87:1327–38.
Huerta PT, et al. Formation of temporal memory requires NMDA receptors within CA1 pyramidal neurons. Neuron. 2000;25:473–80.
Chang EH, et al. Selective impairment of spatial cognition caused by autoantibodies to the N-methyl-d-aspartate receptor. EBioMedicine. 2015;2:755–64.
Chang EH, Frattini SA, Robbiati S, Huerta PT. Construction of microdrive arrays for chronic neural recordings in awake behaving mice. J Vis Exp. 2013;77:e50470. doi:10.3791/50470.
Faust TW, Robbiati S, Huerta TS, Huerta PT. Dynamic NMDAR-mediated properties of place cells during the object place memory task. Front Behav Neurosci. 2013;7:202.
Acknowledgments
We thank Eric H. Chang, Thomas W. Faust, Sergio Robbiati, Stephen A. Frattini, Toby Klein, and all the members of the LOINN (Laboratory of Immune and Neural Networks) for their help in these studies. This research was funded by NIH Grant P01-AI073693 (to B.D., P.H., M.M., B.V.) and NIH Grant P01-AI102852 (to B.D., P.H., K.T., B.V.).
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Patricio T. Huerta, Elizabeth L. Gibson, Carson Rey and Tomás S. Huerta have contributed equally to this work.
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Huerta, P.T., Gibson, E.L., Rey, C. et al. Integrative neuroscience approach to neuropsychiatric lupus. Immunol Res 63, 11–17 (2015). https://doi.org/10.1007/s12026-015-8713-6
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DOI: https://doi.org/10.1007/s12026-015-8713-6