title: Serum neuron specific enolase - a novel indicator for neuropsychiatric systemic lupus erythematosus?
abstract: OBJECTIVE
  Neuropsychiatric (NP) lupus, a common manifestation of systemic lupus erythematosus (SLE), is still insufficiently understood, in part, because of the lack of specific biomarkers. Neuron specific enolase (NSE), an important neuronal glycolytic enzyme, shows increased serum levels following acute brain injury, and decreased serum levels in several chronic disorders of the nervous system, including multi infarct dementia, multiple sclerosis and depression. The aim of the study was to evaluate serum NSE levels in SLE patients with and without nervous system involvement, and in healthy controls, and to assess the correlation of NSE serum levels of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) with clinical parameters.
  
  
  METHODS
  The study comprised 47 SLE patients and 28 controls. SLE activity was assessed using the Systemic Lupus Activity Measure (SLAM). A neurologist and a psychiatrist examined all patients. NP involvement was diagnosed according to strict NPSLE criteria proposed by Ainiala and coworkers, as modification to American College of Rheumatology (ACR) nomenclature and case definitions. NSE serum levels were determined by use of an immunoassay.
  
  
  RESULTS
  Mean NSE serum concentrations in patients with NPSLE were significantly lower than in non-NPSLE patients (6.3 ± 2.6 µg/L vs. 9.7 ± 3.3 µg/L, p < 0.01) and in controls (8.8 ± 3.3 µg/L, p < 0.05). There were significant negative correlations between NSE serum levels and SLE activity (r = -0.42, p < 0.05) and the number of NPSLE manifestations diagnosed (-0.37; p = 0.001).
  
  
  CONCLUSIONS
  Decreased serum concentrations of NSE may reflect chronic neuronal damage with declined metabolism of the nervous tissue in patients with NPSLE.
authors.affiliation: Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Hawro
authors.affiliation: Department of Extrapyramidal Diseases, Medical University of Łódź, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Bogucki
authors.affiliation: Department of Affective and Psychotic Disorders, Medical University of Łódź, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Krupińska-Kun
authors.affiliation: Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany marcus.maurer@charite.de.
authors.forename: M
authors.initials: M
authors.lastname: Maurer
authors.affiliation: Department of Dermatology and Venereology, Medical University of Łódź, Poland marcus.maurer@charite.de.
authors.forename: A
authors.initials: A
authors.lastname: Woźniacka
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001925:Brain Damage, Chronic / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000523:psychology*; D020945:Lupus Vasculitis, Central Nervous System / Q000097:blood / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000134:cerebrospinal fluid / Q000209:etiology; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010751:Phosphopyruvate Hydratase
keywords: Phosphopyruvate hydratase; biomarker; central nervous system diseases; chronic brain damage; neuron specific enolase; systemic lupus erythematosus