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oai:figshare.com:article/34040202 2026-10-01T05:52:38Z category_696 portal_316 item_type_3 month_year_10_2026

Supplementary file 5_The neuropsychiatric systemic lupus erythematosus biomarker landscape: what blood and cerebrospinal fluid analytes have been studied and how they performed? A systematic review and meta-analysis.docx Carolina Muñoz-Grajales (12977207) Sara Duaibes (25152669) Alan Cheng (402218) Yasmin Nariman (25152672) Melanie Anderson (11145655) Dennisse Bonilla (3541346) Sindhu R. Johnson (11762899) Meggan Mackay (367014) Joan Wither (363224) Dafna D. Gladman (4522396) Zahi Touma (5194100) Genetic Immunology autoantibodies biomarkers cerebrospinal fluid cytokines meta-analysis neuroinflammation neuropsychiatric systemic lupus erythematosus systemic lupus erythematosus Objective<p>This study aims to evaluate biomarkers that discriminate systemic lupus erythematosus patients with and without neuropsychiatric involvement.</p>Methods<p>We searched MEDLINE, Embase, and CENTRAL (inception—March 2024) for studies of blood or cerebrospinal fluid (CSF) analytes in neuropsychiatric systemic lupus erythematosus (NPSLE). Random-effects meta-analyses were conducted for analyte-biofluid pairs with ≥5 independent studies; the remaining data were synthesized narratively.</p>Results<p>A total of 93 studies were included. Few analyte–biofluid combinations met the criteria for meta-analysis, and most promising biomarkers (intrathecal inflammation, neuronal injury, and reduced neuroprotection) were assessed in only small, heterogeneous studies. The meta-analyses showed higher CSF IL-6 and MCP-1 in NPSLE than non-NPSLE SLE (Hedges’ g 0.81 and 0.66, respectively), a smaller heterogeneous effect for IL-8, and two- to threefold higher odds of NPSLE in patients positive for serum anti-ribosomal P (OR 2.68, 95% CI 2.03–3.53), anti-NR2/NMDAR (2.09, 1.07–4.06), and IgG anticardiolipin (2.36, 1.56–3.59) antibodies. Compared with non-SLE controls, NPSLE generally showed higher CSF soluble mediators than healthy or non-inflammatory neurological comparators, but the levels in CNS infections were often similar or higher.</p>Conclusion<p>CSF markers of intrathecal inflammation, neuronal injury, and reduced neuroprotection distinguish NPSLE from non-NPSLE SLE but are neither specific for NPSLE nor easily obtainable in routine practice. Classical serum autoantibodies (anti-ribosomal P, anti-NR2, and antiphospholipid antibodies) show modest, phenotype-dependent diagnostic performance. Evidence remains fragmented, with heterogeneous assays, cutoffs, and case definitions, underscoring the need for harmonized multicenter studies to identify robust diagnostic, evaluative, and prognostic biomarkers for overall and manifestation-specific NPSLE.</p> 2026-10-01T05:52:38Z Dataset Dataset 10.3389/fimmu.2026.1903757 https://figshare.com/articles/dataset/Supplementary_file_5_The_neuropsychiatric_systemic_lupus_erythematosus_biomarker_landscape_what_blood_and_cerebrospinal_fluid_analytes_have_been_studied_and_how_they_performed_A_systematic_review_and_meta-analysis_docx/34040202 CC BY 4.0