Brain-reactive lymphocytotoxic antibody in the cerebrospinal fluid of patients with systemic lupus erythematosus: Correlation with central nervous system involvement

Abstract

Lymphocytotoxic activity was measured in the cerebrospinal fluids (CSF) of 21 patients with systemic lupus erythematosus (SLE) and the relationship between that activity and the presence of central nervous system (CNS) involvement was assessed. Lymphocytotoxicity was determined in a dye exclusion microcytotoxicity assay without knowledge of the patient's clinical status. Lymphocytotoxic activity was detected in 10 21 SLE patients. The lymphocytotoxicity was complement dependent, neutralized by anti-immunoglobulin antiserum, and absorbed by normal human brain tissue. CNS involvement was diagnosed in 11 patients, 8 of whom had CSF lymphocytotoxicity. The presence of brain-reactive lymphocytotoxic antibody in CSF correlated with the clinical presence of CNS manifestations ( χ 2 = 3.82, p < 0.05). In addition, lymphocytotoxic activities of CSF from the group of patients with CNS-SLE were significantly greater than those of SLE patients without CNS disease ( P < 0.01). Thus, brain-reactive lymphocytotoxic antibodies in the CSF are indicators of CNS involvement in SLE, and their presence within the CNS supports their potential as pathogenetic mediators.