Replies to post #108921 on Biotech Values

[jq1234]

You are right. Here is the subject from 2003 Lupus:

Lupus. 2003;12(12):908-15.

The blood-brain barrier in systemic lupus erythematosus.
Abbott NJ, Mendonça LL, Dolman DE.

Centre for Neuroscience Research, King's College London, Guy's Campus, London SE1 1UL, UK. [e-mail]

Abstract
Central nervous system (CNS) involvement may occur in 20-70% of systemic lupus erythematosus (SLE) patients where neurological symptoms are overt; this is termed neuropsychiatric lupus or NPSLE. This review summarizes evidence that damage to the brain endothelium forming the blood-brain barrier (BBB) is a contributory factor in NPSLE. The normal CNS is protected by blood-tissue barriers at three sites, the brain endothelium (BBB), the choroid plexus epithelium (blood-CSF barrier) and the arachnoid epithelium. The tight junctions of the barrier layers severely restrict entry of plasma constituents including proteins, so that the CSF and brain interstitial fluid contain low levels of protein. Methods for diagnosing BBB damage include imaging (CT, MRI) using contrast agents, and analysing protein content and profiles of CSF Changes in the albumin quotient Qalbumin show evidence for barrier damage, while changes in the immunoglobulin (Ig) index can indicate intrathecal antibody production. However, BBB damage may be transient, and hence undetected or underestimated. Few mechanistic studies exist, but the two main candidate mechanisms for BBB damage are microthrombi in cerebral vessels leading to ischaemia, and immune-mediated attack and activation of the endothelium leading to local cytokine production. Both can result in barrier breakdown. Neurological syndromes could then be secondary to damage to the BBB. The implications for treatment of NPSLE are discussed.

[genisi]

There are studies showing insults to the BBB in neuropsychiatric SLE (see #msg-56694303), but this is not likely in the case because patients with active central nervous system (CNS) lupus were excluded in the phase III benlysta trials.