Clinical and diagnostic significance of brain-derived neurotrophic factor in patients with systemic lupus erythematosus, relationship with the course of the disease and neuropsychiatric disorders
Summary. Neuropsychological disorders in systemic lupus erythematosus (SLE) are frequent and diverse. The causes and mechanisms of these manifestations remain poorly understood.In recent years, neuropsychiatric disorders have increasingly been associated with a deficiency of Brain Derived Neurotrophic Factor (BDNF). The aim. To study the level of BDNF in the serum of patients with SLE, to assess its relationship with demographic parameters, the activity of the inflammatory process, and to establish its diagnostic value as a possible marker of CNS damage. Materials and methods. 96 patients with SLE aged 19 to 55 years were examined, 7 (7.3%) men and 89 (92.7%) women, the average duration of the disease course was 6.2 ± 0.4 years, the average age was 37.5 ± 0.9 years. The control group consisted of 20 practically healthy individuals, the average age was 39.0 ± 1.09. Assessment of neurological status: Zung depression scale, Spielberger anxiety scale, Montreal cognitive function assessment scale (MoCA), visual and auditory memory tests. The content of BDNF in blood serum was determined by enzyme-linked immunosorbent assay. Results. In patients with SLE, the level of BDNF in the blood serum was 44.7% lower than in the control group. No differences were found in BDNF levels in SLE patients with various comorbid conditions, however, with a decrease in BDNF levels, there was a tendency to an increase in the number of patients with CNS damage. A decrease in BDNF levels was associated with a deterioration in mental health indicators — memory disorders, depressive disorders, cognitive dysfunction and insomnia. The level of BDNF was not associated with the duration of the disease, gender, age, use and dose of GCs, indicators of activity (ESR, CRP, IL-6) of the inflammatory process, with the exception of TNFα and the SLEDAI-1 index. Conclusions. Decreased BDNF levels are associated with CNS damage, high inflammatory activity according to SLEDAI-1 and TNFα, and are not associated with other comorbid conditions, gender, age, or disease duration.
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