To smell autoimmunity: Anti-P-ribosomal autoantibodies, depression, and the olfactory system

Central Nervous System involvement in Systemic Lupus Erythematosus (CNS-SLE) is very common and ranges between 25%–70% of the patients. The CNS involvement is listed in the ARA criteria for SLE diagnosis. CNS-SLE is associated with more than 20 different autoantibodies. Yet, remarkable among them are the anti-P-ribosomal antibodies (anti-PR). These autoantibodies directed mainly against the carboxy 22 amino acids of the PO, P1 P2 ribosomal phosphoproteins. They are capable of penetrating lived cells and inducing apoptotic changes as well as leading to inhibition of specific cytokine secretion. The titer of the autoantibodies correlate with disease activity, kidney involvement and hepatitis. In this review, the mechanisms involved in CNS involvement and its relationship with anti-P ribosomal antibodies will be described.