Temporal Association Between Daily Alcohol Consumption, Emotional States and Urinary Neopterin Levels in a Patient with Systemic Lupus Erythematosus

Abstract

Abstract In recent years, interest has been growing regarding the role of alcohol intake on systemic lupus erythematosus (SLE) disease activity. This integrative single-case study investigated the dynamic interdependencies between alcohol consumption, various emotional states and cellular immune activity in SLE using time series analysis (i.e., ARIMA modeling, cross-correlational analysis). We determined neopterin concentrations (HPLC) in a 52-year-old woman suffering from SLE, who collected her entire urine on a twice-daily basis for a period of 56 days (total: 112 time-points). Aside from the central interest of our studies, i.e., the impact of everyday incidents on cellular immune system dynamics, the patient also provided daily information on intake of alcoholic beverages (type and quantity) and various emotional state variables (mental activity, irritation, mood). Cross-correlational analyses revealed that moderate alcohol consumption had different effects on urinary neopterin levels depending on whether time series data were analyzed before or after the occurrence of an inflammatory event (acute paranasal sinusitis) that had taken place halfway through the study period (time-points 45-54). Before sinusitis (1-44), increases in alcohol consumption were parallelized by decreases in urinary neopterin levels (lag0: r = -0.371; p< 0.05) whereas after sinusitis (55-112), increases in alcohol intake preceded increases in urinary neopterin levels with a temporal delay of 12 hours (lag1: r = +0.308; p< 0.05). The emotional states under study did not interfere with the associations between alcohol intake and neopterin levels. These findings show that even within the same patient with SLE the relationship between alcohol intake and neopterin levels might not always be stable suggesting a possible reason for inconsistent evidence from cross-correlational studies.