Abstract Details

Title Blood-based Biomarkers of Neuronal and Glial Damage in Active Major Neuropsychiatric Systemic Lupus Erythematosus

Topic Autoimmune Neurology

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 14-012

Background

NPSLE is a poorly understood and heterogeneous manifestation of SLE; more common major NPSLE syndromes include strokes, seizures, myelitis, and aseptic meningitis. Easily obtainable biomarkers are needed to assist in early diagnosis and improve outcomes. A likely common end-result of the heterogeneous major syndromes is neuronal/glial injury. Blood NfL and GFAP are promising markers of these in other neurologic diseases; however, they have not yet been evaluated in active major NPSLE (amNPSLE).

Objective

To determine the relationship of blood neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in persons with systemic lupus erythematosus (SLE) with and without active major neuropsychiatric (NP) systemic lupus erythematosus (NPSLE)

Design/Methods

In a case-control study, we prospectively enrolled or retrospectively identified patients aged 12-60 years (y) with SLE. Adjudicated cases with and disease controls without amNPSLE were included. Active NPSLE was defined as <6 months from last new/worsening NP symptom. Demographics, clinical data, and serum or plasma biosamples were obtained. Biomarker levels were assessed using the Simoa® Neurology 4-PLEX B assay.

Results

Eleven patients with amNPSLE and 11 age/sex matched SLE controls without amNPSLE (mean age 27.0 vs 27.4 y, 91% female) were included. Major syndromes were non-exclusive, including demyelinating disease (2), autonomic disorder (3), cranial neuropathy (1), seizures (1), myelopathy (1), aseptic meningitis (2), stroke (4), and sensorimotor polyneuropathy (2). Using a generalized linear model, the estimated average blood NfL and GFAP were 4.7 and 59.1 pg/ml, respectively, for SLE controls. Blood NfL was on average 17.4 pg/ml higher (95% CI, 8.0, 37.6; p <0.001), and blood GFAP was 5.7 pg/ml higher (95% CI, 2.7, 12.0; p <0.001) in patients with amNPSLE compared to SLE controls.

Conclusions

Blood NfL and GFAP levels are elevated in persons with SLE with amNPSLE compared to disease matched controls. Larger studies are needed to ascertain their utility in a clinical setting.

Authors/Disclosures
Ryan Kammeyer, MD (Childrens Hospital Colorado) PRESENTER	The institution of Dr. Kammeyer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Kammeyer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Ogborn-Mihm Trial Lawyers. The institution of Dr. Kammeyer has received research support from Rocky Mountain Multiple Sclerosis Center.
Kimberly Chapman (Cu Anschutz)	No disclosure on file
Anna Furniss (University of Colorado)	No disclosure on file
Ekemini Ogbu (Cincinnati Children's Hospital Medical Center)	No disclosure on file
Kavita Nair, PhD, FAAN (University of Colorado)	Dr. Nair has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Nair has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for PhRMA Foundation. Dr. Nair has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MJH Healthcare. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Nair has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Anylam . Dr. Nair has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sanofi-Genzyme. The institution of Dr. Nair has received research support from Genentech. The institution of Dr. Nair has received research support from Novartis. The institution of Dr. Nair has received research support from Genentech. The institution of Dr. Nair has received research support from Phrma Foundation. The institution of Dr. Nair has received research support from Bristol Meyers Squibb. The institution of Dr. Nair has received research support from Novartis. The institution of Dr. Nair has received research support from NINDS.
Tyler L. Borko, BA (University of Colorado)	Mr. Borko has nothing to disclose.
Robert Fuhlbrigge (Children's Hospital Colorado)	No disclosure on file
Jeffrey L. Bennett, MD, PhD, FAAN (University of Colorado School of Medicine)	Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon Therapeutics. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Bennett has received personal compensation in the range of $0-$499 for serving as a Consultant for Genentech. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Chugai. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ImCyse. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Beigene. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Pavich. The institution of Dr. Bennett has received research support from Alexion. Dr. Bennett has received intellectual property interests from a discovery or technology relating to health care. Dr. Bennett has received publishing royalties from a publication relating to health care.
Susan Boackle	No disclosure on file
Elena Hsieh (University of Colorado Denver)	No disclosure on file
JoAnn Zell	No disclosure on file
Jennifer Cooper (Children's Hospital Colorado)	No disclosure on file
Amanda L. Piquet, MD, FAAN (University of Colorado)	The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. The institution of Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. The institution of Dr. Piquet has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. The institution of Dr. Piquet has received personal compensation in the range of $0-$499 for serving as a Consultant for EMD Serono. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Piquet has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Sands Anderson PC. Dr. Piquet has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Joe Jones Law Firm. The institution of Dr. Piquet has received research support from Rocky Mountain MS Center. The institution of Dr. Piquet has received research support from Novartis. The institution of Dr. Piquet has received research support from Abbvie. The institution of Dr. Piquet has received research support from Roche/Genentech. The institution of Dr. Piquet has received research support from NYU. The institution of Dr. Piquet has received research support from Anokion. The institution of Dr. Piquet has received research support from UCB . The institution of Dr. Piquet has received research support from Foundation for Sarcoidosis. Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received publishing royalties from a publication relating to health care. Dr. Piquet has received personal compensation in the range of $10,000-$49,999 for serving as a Litigative Consultant with US-Dept HHS/DICP. Dr. Piquet has a non-compensated relationship as a Medical Advisory Board Member with Autoimmune Encephalitis Alliance (AEA) that is relevant to AAN interests or activities. Dr. Piquet has a non-compensated relationship as a Medical Advisory Board Member with Stiff Person Syndrome Research Foundation (SPSRF) that is relevant to AAN interests or activities.