title: Change in autoantibody and cytokine responses during the evolution of neuromyelitis optica in patients with systemic lupus erythematosus: A preliminary study.
abstract: Neuromyelitis optica (NMO)-systemic lupus erythematosus (SLE) association is a rare condition characterized by multiple autoantibodies.
  
  
  
  To examine if, during the evolution of NMO, anti-AQP4 responses are part of polyclonal B cell activation, and if T cell responses contribute.
  
  
  
  In 19 samples of six patients who developed NMO during SLE, we examined the correlation of AQP4-IgG1 and IgM with (i) anti-MOG IgG and IgM, (ii) anti-nuclear, anti-nucleosome and anti-dsDNA IgG antibodies, (iii) cytokines and chemokines in the serum and (iv) longitudinal relation to NMO relapses/remission.
  
  
  
  AQP4-IgG1 was present 1-2-5 years before the first NMO relapse. During relapse, AQP4-IgG1, ANA, anti-dsDNA and anti-nucleosome antibodies were elevated. Anti-MOG IgG/IgM and AQP4-IgM antibodies were not detected. AQP4-IgG1 antibodies correlated with concentration of anti-nucleosome, IFN-γ,interferon-gamma-induced CCL10/IP-10 and CCL17/TARC (p<0.05, respectively). CCL17/TARC correlated with levels of anti-nucleosome and anti-dsDNA (p<0.05, respectively). Compared to healthy subjects, concentration of IFN-γ and CCL17/TARC was higher in NMO/SLE (p<0.05).
  
  
  
  AQP4-IgG1 antibodies are present in the sera years before the first NMO attack in patients with SLE; elevation of anti-AQP4 is part of a polyclonal B cell response during NMO relapses; in spite of multiple autoantibodies in the serum, MOG antibodies were not present; Th1 responses accompany autoantibody responses in NMO/SLE.
authors.affiliation: Department of Rheumatology and Immunology, University of Pecs, Hungary.
authors.forename: Katalin T
authors.initials: KT
authors.lastname: Kovacs
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany.
authors.forename: Sudhakar Reddy
authors.initials: SR
authors.lastname: Kalluri
authors.affiliation: Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Sweden.
authors.forename: Antonio
authors.initials: A
authors.lastname: Boza-Serrano
authors.affiliation: Department of Experimental Medical Science, Experimental Neuroinflammation Laboratory, Lund University, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Deierborg
authors.affiliation: Department of Neurology, University of Debrecen, Hungary.
authors.forename: Tunde
authors.initials: T
authors.lastname: Csepany
authors.affiliation: Department of Neurology, Semmelweis University, Hungary.
authors.forename: Magdolna
authors.initials: M
authors.lastname: Simo
authors.affiliation: 1st Department of Internal Medicine, Military Hospital - State Health Centre, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Rokusz
authors.affiliation: Department of Laboratory Medicine, University of Pecs, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Miseta
authors.affiliation: Computational Biology Group, Department of Mathematics and Computer Science (IMADA), University of Southern Denmark, Denmark.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Alcaraz
authors.affiliation: Department of Rheumatology and Immunology, University of Pecs, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Czirjak
authors.affiliation: Department of Immunology and Biotechnology, University of Pecs, Hungary.
authors.forename: Timea
authors.initials: T
authors.lastname: Berki
authors.affiliation: Department of Anesthesiology and Intensive Care, University of Pecs, Hungary.
authors.forename: Tihamer
authors.initials: T
authors.lastname: Molnar
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Germany/Munich Cluster for Systems Neurology (SyNergy), Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hemmer
authors.affiliation: Department of Neurology, Odense University Hospital, Denmark/Institute of Clinical Research, University of Southern Denmark, Denmark zsolt.illes@rsyd.dk.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Illes
mesh_terms: D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D001402:B-Lymphocytes / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002648:Child; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008213:Lymphocyte Activation; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D000074286:Preliminary Data; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism; D058504:Th17 Cells / Q000276:immunology / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; D016207:Cytokines; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents
keywords: AQP4; IL-17; IP-10; SLE; Th1; Th17; myelin oligodendrocyte glycoprotein