Quantitation of C3 nephritic factor of alternative complement pathway by an enzyme-linked immunosorbent assay

A novel ELISA assay for the detection of C3 nephritic factor

We have developed an ELISA procedure for the detection of C3 nephritic factor (C3NeF), in which wells are coated with a fixed concentration of 2 micrograms C3b per well, and subsequently reacted with B and D. The presence of increasing concentrations of NiCl2 showed a NiCl2 concentration-dependent generation of C3bBb and very little solid-phase bound C3bBb was generated with MgCl2. The formation of solid-phase C3bBb in the presence of an optimal concentration of 1 mM NiCl2, was time-dependent and plateau values were reached after 30 min at 37 degrees C. IgG purified from the serum of a patient with membranoproliferative glomerulonephritis (MPGN) type II containing C3NeF stabilizing activity was bound to the C3bBb generated on microwells in a dose-dependent manner whereas normal IgG exhibited only minor reactivity. C3NeF activity was measured using the ELISA method in patients with MPGN type II (n = 15) and other diseases (n = 17) and in normal controls (n = 15). Most of the patients with MPGN type II exhibited positive C3NeF at various levels, while two of the disease controls showed only slight reactivities. C3NeF titers measured by this new ELISA procedure correlated well with previously described hemolytic assays (r = 0.617, p < 0.01).

Circulating anti-DNA immune complexes in active lupus nephritis

PURPOSE

The role that circulating anti-DNA immune complexes play in autoimmunity has not yet been elucidated in humans. The aim of this study was to relate circulating anti-DNA immune complexes to a variety of renal histologic features and to immunoglobulin deposits in active lupus nephritis.

PATIENTS AND METHODS

The study population consisted of 47 patients with active lupus nephritis, 28 with active systemic lupus erythematosus (SLE) in the absence of renal lesions, and 40 with other categories of the disease. All patients were examined for anti-DNA circulating immune complexes (CIC) and their anti-DNA idiotype expression by an isoelectrofocusing analysis. Patients with renal lesions were also examined for renal histologic and immunofluorescent findings in renal biopsy specimens.

RESULTS

Anti-DNA CIC expressing an anti-DNA idiotype termed 0-81 Id occurred in patients with active lupus nephritis but not in acute episodes lacking renal involvement or in remission. Positive test results for anti-DNA CIC were associated with the incidence of diffuse proliferative glomerulonephritis (DPGN). Patients with anti-DNA CIC were also found to have a statistically significant increase in the prevalence of immunoglobulin immune deposits in the subendothelial area of the renal glomeruli.

CONCLUSION

The findings suggest that anti-DNA CIC preferentially occurred in lupus patients with DPGN. Examination for anti-DNA CIC may be a useful predictor of renal lesions, and therefore may contribute to the management of SLE. The results also indicate that anti-DNA CIC may be associated with immunoglobulin deposition in the subendothelial area of the renal glomeruli.

Heterogeneity of immune complex-derived anti-DNA antibodies associated with lupus nephritis

The mechanisms responsible for the tissue injuries associated with lupus nephritis have not yet been well explained. We have investigated the characteristics of anti-DNA antibodies in circulating immune complexes (CIC) and in the deposits of renal glomeruli in patients with active lupus nephritis. The CIC-derived antibodies expressed anti-DNA idiotypes (Id) designated as 0-81 Id and NE-1 Id, and bound mainly to single-stranded DNA but never to glomerular basement membrane (GBM) antigens. On the other hand, the immunoglobulins (Ig) eluted from renal glomeruli of lupus patients reacted not only with DNA but also with GBM, proteoglycan, and heparan sulfate. The binding of glomeruli-deposited Ig was markedly low when GBM antigens were used after treatment with heparitinase, suggesting that some anti-DNA antibodies may bind directly to GBM antigens associated with heparan sulfate, and form in situ IC in renal glomeruli. It was also revealed that the renal eluates obtained after passing through GBM antigen-coupled Sepharose lost the binding ability with GBM but still retained DNA-binding and 0-81 Id activity, showing the participation of circulating IC-derived anti-DNA antibodies in the glomerular deposits. Theoretically there may be two mechanisms in the pathogenesis of lupus nephritis through the deposition of circulating IC and through in situ formation of anti-DNA IC in renal glomeruli. The diversity of histological features in lupus kidneys may be attributed to the heterogeneity of the mechanisms.

Quantitation of C4 nephritic factor by an enzyme-linked immunosorbent assay

We have developed an enzyme-linked immunosorbent assay (ELISA) for the quantitation of C4 nephritic factor (C4NeF). Incubation of the C4NeF-positive serum from patient M.I. with normal human serum (NHS) in the presence of human aggregated IgG (AHG) resulted in the formation of stable C4-C2 complex. No complex was formed in EDTA or under the condition free of AHG. The reaction mixture was filtered through an ACA 22 column, from which the C4-C2 complex was eluted at the first protein peak. When IgG purified from M.I. serum was incubated with NHS and AHG, C4-C2 complex also increased in proportion to dose of the purified M.I. IgG. These results show that C4NeF in M.I. serum stabilizes C4b2a convertase of the classical complement pathway, and is quantified by the ELISA. C4NeF activity was measured, using the ELISA method, in patients with various glomerular diseases, and found elevated in three of 24 patients with membranoproliferative glomerulonephritis (MPGN) type I and slightly but distinctly positive in seven of 24. No C4NeF was detected in two C3 nephritic factor-positive patients with MPGN type II and six with active systemic lupus erythematosus. The new method was more simple and quantitative than C4b2a stabilization assay for C4NeF.