Blood-brain barrier disruption and neuroinflammation as pathophysiological mechanisms of the diffuse manifestations of neuropsychiatric systemic lupus erythematosus

Autoimmun Rev. 2019 Apr;18(4):426-432. doi: 10.1016/j.autrev.2018.12.004. Epub 2019 Feb 11.

Abstract

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease that can involve nervous system commitment known as neuropsychiatric systemic lupus erythematosus (NPSLE). The diagnostic of NPSLE is complex because the symptoms range from focal symptoms (e.g., strokes, thrombotic events) to diffuse disorders affecting cognition, mood and level of consciousness (e.g. acute confusional state, psychosis). Both type of manifestations of NPSLE differ in their pathological mechanisms. The focus of this review will be on the mechanisms that lead to the blood-brain barrier (BBB) disruption and to the neuroinflammation related with the diffuse manifestations of NPSLE.

Keywords: Autoantibodies; Blood-brain barrier and mechanisms; Complement; Cytokines; Neuropsychiatric systemic lupus erythematosus.

Publication types

  • Review

MeSH terms

  • Blood-Brain Barrier / immunology
  • Blood-Brain Barrier / metabolism
  • Blood-Brain Barrier / pathology*
  • Cell Membrane Permeability / physiology
  • Encephalitis / complications*
  • Encephalitis / immunology
  • Humans
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Vasculitis, Central Nervous System / etiology*
  • Lupus Vasculitis, Central Nervous System / immunology
  • Lupus Vasculitis, Central Nervous System / pathology
  • Neuroimmunomodulation / physiology