Association between inflammatory cytokine concentration and cognitive function and stress among systemic lupus erythematosus patients Open Access

Song, Jiawei (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/2v23vt426?locale=en
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Abstract

Systemic lupus erythematous (SLE) is an autoimmune disease that causes the body’s immune system to attack the healthy tissue in many parts of the body, leading to widespread inflammation. To our knowledge, the associations between cytokines and cognitive function and stress among SLE patients have never been systematically evaluated. To address this, we examined plasma concentrations of 10 different immune molecules (CRP, ICAM, VCAM, E-selectin, MIF, VEGF, TNF-α, IL-6, IFN-γ, IL-17a), among SLE patients who participated in a pilot study of functioning and had available samples (n=27). In the pilot, cognitive performance on five individual domains (episodic memory, working memory, cognitive flexibility, processing speed, and inhibitory control/attention) was assessed and reported as adjusted t-scores (range 0-100, with 50 representing the average score for individuals of the same age, sex, race/ethnicity, and educational attainment). Overall scores for fluid cognition, or overall capacity to reason and solve novel problems were also calculated. Participants’ perceived stress was assessed during the pilot study visit using the 14-item Perceived Stress Scale (PSS-14; range 0-56; higher scores indicating greater perceived stress).

In regression models with cognitive score as the outcome variable, concentrations of E-selectin (ng/ml, beta=0.81, p=0.044) and VCAM (ug/ml, beta=-9.1, p=0.014) were statistically significantly associated with overall fluid cognition. After controlling for the time interval between blood draw and cognitive assessment, E-selectin (ng/ml, beta=0.81, p=0.047) and VCAM (ug/ml, beta=-12.5, p=0.008) remained associated with overall fluid cognition. Concentrations of VEGF (ng/ml, beta=-29, p=0.043) and TNF-α (pg/ml, beta=-7.15, p=0.023) were statistically significantly associated with overall fluid cognition only after this adjustment; however, this association was rendered non-statistically significant after removal of an outlier. All other remaining biomarkers were not associated with fluid cognition. When considering individual cognitive domains, E-selectin was associated with better inhibitory control and attention (beta=0.62, p=0.025), cognitive flexibility (beta=0.86, p=0.036) and processing speed (beta=0.90, p=0.044), while TNF-α (beta=-5.78, p=0.046) and VCAM (beta=-7.69, p=0.038) were associated with worse working memory. We found no association between biomarker concentration and perceived stress score among SLE patients. In conclusion, we found that E-selectin and VCAM levels were associated with the higher and lower, respectively, overall fluid cognition performance in SLE patients. The results provide some specific potential biomarker targets, which may help understand cognitive impairment or decline among SLE patients.

Table of Contents

Table of Contents Introduction ................................................................................................................. 1 Materials and Methods ................................................................................................ 4 Results ......................................................................................................................... 8 Discussion ................................................................................................................. 11 Table and Figures ...................................................................................................... 16 References ................................................................................................................. 27

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