Clinical Significance of Cytokines and Chemokines in Neuropsychiatric Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a complex multisystem autoimmune disease with a relapsing and remitting course, and neuropsychiatric complications of SLE (NPSLE) are associated with increased morbidity and mortality. In general, the diagnosis of NPSLE is difficult because no single laboratory marker or imaging modality serves as a gold standard, and the diagnosis is primarily clinical. However, recent studies have provided evidence that many cytokines and chemokines, as well as autoantibodies, may be involved in the neuropsychiatric manifestations of SLE. This is supported by the finding that several repertoires of cytokines/chemokines are detectable in the central nervous systems of NPSLE patients during active disease. In addition, we have recently shown elevated levels of the soluble form of CX3CL1, amembrane- bound CX3C chemokine, in the cerebrospinal fluid of patients with active NPSLE. This review will discuss the involvement of cytokines and chemokines in the pathogenesis of NPSLE and evaluate their significance as a useful laboratory parameter of active neuropsychiatric disease.