1
|
Yang Y, Huang D, Liu C, Zhong N, Peng Y, Wang L, Xiao L, Zhao W. Early diagnosis and clinical application of systemic lupus erythematosus based on a nomogram model. Heliyon 2024; 10:e24523. [PMID: 38304801 PMCID: PMC10830536 DOI: 10.1016/j.heliyon.2024.e24523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multi-system and multi-organ dysfunction, and is easily misdiagnosed early in the disease course. We aimed to accurately predict early SLE nomogram to provide a reference basis for the early clinical diagnosis of SLE. Methods: We retrospectively analyzed 167 patients who were first diagnosed with SLE at Fengxian District Central Hospital, Shanghai, between March 2017 and October 2022. Three groups of 129 physically healthy subjects, 67 patients with rheumatoid arthritis, and 40 patients with rashes were selected as controls during the same period. Patients with SLE and control group were randomly divided into training (n = 217) and validation (n = 141) group. Univariate and multivariate analyses were used to identify independent risk factors for early SLE diagnosis. The independent risk factors for diagnosis were used to construct a nomogram to predict early SLE. Results: Based on the training group, three variables were identified as independently influencing early SLE: platelets (odds ratio OR = 0.993, P = 0.047), albumin (OR = 0.833, P = 0.007), and complement component 1q (OR = 0.956, P = 0.000). The precision of the nomogram was assessed using C-index values and calibration plot diagrams. The C-index values were 0.929 for training group and 0.898 for validation group. Both the training group and validation group calibration curves showed good predicted outcomes. Conclusion: The construction of a nomogram can accurately predict the risk of early SLE. The model showed good discriminatory power and calibration for use in the diagnosis of SLE, providing a visual tool and reference basis for the early diagnosis of SLE.
Collapse
Affiliation(s)
- Yalin Yang
- Department of Microbiology Laboratory, Linfen Central Hospital, Linfen, 041000, China
| | - Dingding Huang
- Department of Anesthesiology, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - Cuicui Liu
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - Ningxuan Zhong
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - You Peng
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - Lulu Wang
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - Linlin Xiao
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| | - Weiwei Zhao
- Department of Laboratory Medicine, Affiliated Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201499, China
| |
Collapse
|
2
|
Damoiseaux J, van Beers J. Autoantibodies to dsDNA in the diagnosis, classification and follow-up of patients with systemic lupus erythematosus. J Transl Autoimmun 2023; 6:100191. [PMID: 36718274 PMCID: PMC9883238 DOI: 10.1016/j.jtauto.2023.100191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/20/2023] [Indexed: 01/23/2023] Open
Abstract
Autoantibodies, in particular anti-dsDNA antibodies, are increasingly used for diagnosis, classification and follow-up of patients with SLE. Since standardization of autoantibody assays is a major challenge, more attention should be paid to harmonization initiatives and better definition of required test characteristics in classification criteria. For diagnosis and follow-up separate multi-center studies are required to establish test characteristics of distinct immuno-assays for both purposes. Finally, such studies should consider not to evaluate SLE as a single disease, but as a disease with distinct subtypes.
Collapse
Affiliation(s)
- Jan Damoiseaux
- Corresponding author. Central Diagnostic Laboratory, Maastricht University Medical Center, P. Debyelaan 25, 6229HX, Maastricht, the Netherlands.
| | | |
Collapse
|
3
|
Wang L, Yang Z, Yu H, Lin W, Wu R, Yang H, Yang K. Predicting diagnostic gene expression profiles associated with immune infiltration in patients with lupus nephritis. Front Immunol 2022; 13:839197. [PMID: 36532018 PMCID: PMC9755505 DOI: 10.3389/fimmu.2022.839197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/09/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To identify potential diagnostic markers of lupus nephritis (LN) based on bioinformatics and machine learning and to explore the significance of immune cell infiltration in this pathology. Methods Seven LN gene expression datasets were downloaded from the GEO database, and the larger sample size was used as the training group to obtain differential genes (DEGs) between LN and healthy controls, and to perform gene function, disease ontology (DO), and gene set enrichment analyses (GSEA). Two machine learning algorithms, least absolute shrinkage and selection operator (LASSO) and support vector machine-recursive feature elimination (SVM-RFE), were applied to identify candidate biomarkers. The diagnostic value of LN diagnostic gene biomarkers was further evaluated in the area under the ROC curve observed in the validation dataset. CIBERSORT was used to analyze 22 immune cell fractions from LN patients and to analyze their correlation with diagnostic markers. Results Thirty and twenty-one DEGs were screened in kidney tissue and peripheral blood, respectively. Both of which covered macrophages and interferons. The disease enrichment analysis of DEGs in kidney tissues showed that they were mainly involved in immune and renal diseases, and in peripheral blood it was mainly enriched in cardiovascular system, bone marrow, and oral cavity. The machine learning algorithm combined with external dataset validation revealed that C1QA(AUC = 0.741), C1QB(AUC = 0.758), MX1(AUC = 0.865), RORC(AUC = 0.911), CD177(AUC = 0.855), DEFA4(AUC= 0.843)and HERC5(AUC = 0.880) had high diagnostic value and could be used as diagnostic biomarkers of LN. Compared to controls, pathways such as cell adhesion molecule cam, and systemic lupus erythematosus were activated in kidney tissues; cell cycle, cytoplasmic DNA sensing pathways, NOD-like receptor signaling pathways, proteasome, and RIG-1-like receptors were activated in peripheral blood. Immune cell infiltration analysis showed that diagnostic markers in kidney tissue were associated with T cells CD8 and Dendritic cells resting, and in blood were associated with T cells CD4 memory resting, suggesting that CD4 T cells, CD8 T cells and dendritic cells are closely related to the development and progression of LN. Conclusion C1QA, C1QB, MX1, RORC, CD177, DEFA4 and HERC5 could be used as new candidate molecular markers for LN. It may provide new insights into the diagnosis and molecular treatment of LN in the future.
Collapse
Affiliation(s)
- Lin Wang
- Nephrology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhihua Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hangxing Yu
- Nephrology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wei Lin
- Nephrology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ruoxi Wu
- Nephrology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongtao Yang
- Nephrology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Kang Yang
- Nephrology Department, The First Affiliated Hospital of Henan University of Chinese Medicine, Henan, China
| |
Collapse
|
4
|
Rabatscher PA, Trendelenburg M. Anti-C1q autoantibodies from systemic lupus erythematosus patients enhance CD40-CD154-mediated inflammation in peripheral blood mononuclear cells in vitro. Clin Transl Immunology 2022; 11:e1408. [PMID: 35928801 PMCID: PMC9345742 DOI: 10.1002/cti2.1408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/09/2022] [Accepted: 07/14/2022] [Indexed: 01/03/2023] Open
Abstract
Objectives Systemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease with complex pathogenic mechanisms. Complement C1q has been shown to play a major role in SLE, and autoantibodies against C1q (anti‐C1q) are strongly associated with SLE disease activity and severe lupus nephritis suggesting a pathogenic role for anti‐C1q. Whereas C1q alone has anti‐inflammatory effects on human monocytes and macrophages, C1q/anti‐C1q complexes favor a pro‐inflammatory phenotype. This study aimed to elucidate the inflammatory effects of anti‐C1q on peripheral blood mononuclear cells (PBMCs). Methods Isolated monocytes, isolated T cells and bulk PBMCs of healthy donors with or without concomitant T cell activation were exposed to C1q or complexes of C1q and SLE patient‐derived anti‐C1q (C1q/anti‐C1q). Functional consequences of C1q/anti‐C1q on cells were assessed by determining cytokine secretion, monocyte surface marker expression, T cell activation and proliferation. Results Exposure of isolated T cells to C1q or C1q/anti‐C1q did not affect their activation and proliferation. However, unspecific T cell activation in PBMCs in the presence of C1q/anti‐C1q resulted in increased TNF, IFN‐γ and IL‐10 secretion compared with C1q alone. Co‐culture and inhibition experiments showed that the inflammatory effect of C1q/anti‐C1q on PBMCs was due to a direct CD40–CD154 interaction between activated T cells and C1q/anti‐C1q‐primed monocytes. The CD40‐mediated inflammatory reaction of monocytes involves TRAF6 and JAK3‐STAT5 signalling. Conclusion In conclusion, C1q/anti‐C1q have a pro‐inflammatory effect on monocytes that depends on T cell activation and CD40–CD154 signalling. This signalling pathway could serve as a therapeutic target for anti‐C1q‐mediated inflammation.
Collapse
Affiliation(s)
| | - Marten Trendelenburg
- Laboratory of Clinical Immunology, Department of Biomedicine University of Basel Basel Switzerland.,Division of Internal Medicine University Hospital Basel Basel Switzerland
| |
Collapse
|
5
|
Alwahaibi N, Al-Khazimi O, Al-Riyami M. Histopathological Spectrum of Glomerular Diseases in Oman: A Five-year Study. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2022; 33:425-431. [PMID: 37843144 DOI: 10.4103/1319-2442.385966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Glomerular diseases are numerous and difficult to diagnose without a renal biopsy. Despite the development of many radiological and laboratory tests and the use of up-to-date equipment, renal biopsies are the best method for diagnosing renal diseases. This study aimed to analyze the histopathological patterns of glomerular diseases in Oman. Light microscopy and immunofluorescence markers such as immunoglobulin (Ig) G, IgA, IgM, C3, and C1q, which are routinely used to evaluate the presence of immune deposits, were analyzed. In total, 596 renal biopsies were retrospectively analyzed at the Sultan Qaboos University Hospital for a 5-year period (2011-2015). Males represented 45.8%, and the median age was 29.7 years. Primary glomerular diseases were more common in males (54%); secondary glomerular diseases were more prevalent among females (76.7%). The prevalence of primary glomerular diseases (65.6%) was more dominant than secondary glomerular diseases (34.4%). Lupus nephritis (LN) was the most common secondary glomerular disease and was the most prevalent among all biopsies (29.9%). Focal segmental glomerulosclerosis (FSGS), membranous glomerulopathy, IgA nephropathy, minimal change disease, and diffuse global glomerulosclerosis were the most common primary glomerular diseases, accounting for 21.5%, 9.1%, 8.6%, 6.4%, and 6.2%, respectively. The level of the fluorescein isothiocyanate C1q marker in the top five renal diseases was low compared with other markers. In conclusion, in Oman, LN was the most common glomerular disease encountered and FSGS was the most common primary glomerular disease. The findings suggest that the localization of glomerular C1q in renal diseases needs to be investigated further.
Collapse
Affiliation(s)
- Nasar Alwahaibi
- Department of Biomedical Science, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Owias Al-Khazimi
- Department of Biomedical Science, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Marna Al-Riyami
- Department of Pathology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
6
|
Kianmehr N, Khoshmirsafa M, Shekarabi M, Falak R, Haghighi A, Masoodian M, Seif F, Omidi F, Shirani F, Dadfar N. High frequency of concurrent anti-C1q and anti-dsDNA but not anti-C3b antibodies in patients with Lupus Nephritis. J Immunoassay Immunochem 2021; 42:406-423. [PMID: 33788670 DOI: 10.1080/15321819.2021.1895215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Lupus Nephritis (LN) in patients with Systemic Lupus Erythematosus (SLE) is one of the most serious and prevalent manifestations. The procedure of renal biopsy is harmful and accompanied by potential hazards. Therefore, introducing reliable biomarkers to predict LN is exceedingly worthwhile. In the present study, we compared the diagnostic values of circulating autoantibodies against dsDNA, C1q, C3b, SSA, SSB, and Sm alone or in combination to predict LN. This study evaluated the abovementioned autoantibodies in 40 healthy controls (HCs) and 95 SLE patients with different kidney involvements, including absent (n = 40), inactive (n = 20), and active (n = 35) LN using EIA method. The frequency and odds ratio of anti-dsDNA (71.4%, OR = 4.2), anti-C1q (62.9%, OR = 5.1), and the simultaneous existence of anti-C1q and anti-dsDNA (51.4%, OR = 6) antibodies were significantly higher in the active LN group compared with both inactive and absent LN groups. Moreover, the levels of anti-C1q and anti-dsDNA antibodies positively correlated with disease activity in patients with SLE. The prevalence of these autoantibodies was associated with the severity of LN biopsies. These data suggest that anti-C1q and anti-dsDNA antibodies and also their simultaneous presence may be valuable diagnostic biomarkers for LN prediction in patients with SLE.
Collapse
Affiliation(s)
- Nahid Kianmehr
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khoshmirsafa
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shekarabi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Immunology Research Center, Institute of Immunology and Infectious Diseases Iran University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Masoodian
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Seif
- Academic Center for Education, Culture and Research, Tehran, Iran
| | - Forouzan Omidi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shirani
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Dadfar
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Shang X, Ren L, Sun G, Yu T, Yao Y, Wang L, Liu F, Zhang L, He X, Liu M. Anti-dsDNA, anti-nucleosome, anti-C1q, and anti-histone antibodies as markers of active lupus nephritis and systemic lupus erythematosus disease activity. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:407-418. [PMID: 33470559 PMCID: PMC8127563 DOI: 10.1002/iid3.401] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023]
Abstract
Introduction Previous studies of anti‐dsDNA, nucleosome (Nucl), histone (His), and C1q antibodies have revealed their clinical value in systemic lupus erythematosus (SLE). However, the correlation between four autoantibodies and SLE activity, lupus nephritis (LN) remains controversial, and data are insufficient on longitudinal monitoring. This study aimed at evaluating the value of these autoantibodies in active LN, and their performance on cross‐sectional evaluating and longitudinal monitoring of SLE disease activity. Methods Serum levels of four autoantibodies in 114 SLE patients, 219 other autoimmune disease patients (OAD), and 59 healthy controls were assayed by a quantitative immunoassay. Sera of 38 inpatients were obtained again after treatment. Results We found that serum levels of four autoantibodies were significantly higher in SLE than OAD patients (p < 001), active LN than non‐renal SLE patients (p < .05), and higher in SLE patients with moderate and severe disease activity than mild disease activity (p < .01). Horizontally, serum level of each autoantibody was correlated with SLE disease activity index (SLEDAI) (p < .05), and correlation coefficient of anti‐dsDNA was the highest (r = .585). For longitudinal monitoring, the decreased levels of four autoantibodies were found following treatment (p < .001). Serum level variations of these antibodies were positively correlated with variations of SLEDAI (p < .05). The correlation coefficient of anti‐Nucl was the highest (r = .629). Although the levels of C3 and C4 increased after treatment, the change was not related to the change of SLEDAI (p > .05). Conclusions Anti‐C1q, anti‐dsDNA, anti‐Nucl, and anti‐His perform well in diagnosing active LN and monitoring SLE disease activity. They could be indicators of active LN and SLE disease activity.
Collapse
Affiliation(s)
- Xiaoying Shang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Clinical Laboratory, Qingdao Municipal Hospital, Qingdao, China
| | - Lisheng Ren
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guirong Sun
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Teng Yu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Yao
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fenghai Liu
- Department of Clinical Laboratory, Qingdao Municipal Hospital, Qingdao, China
| | - Lijun Zhang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaqin He
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingjun Liu
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| |
Collapse
|
8
|
Harris CL, Pouw RB, Kavanagh D, Sun R, Ricklin D. Developments in anti-complement therapy; from disease to clinical trial. Mol Immunol 2018; 102:89-119. [PMID: 30121124 DOI: 10.1016/j.molimm.2018.06.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 02/06/2023]
Abstract
The complement system is well known for its role in innate immunity and in maintenance of tissue homeostasis, providing a first line of defence against infection and playing a key role in flagging apoptotic cells and debris for disposal. Unfortunately complement also contributes to pathogenesis of a number of diseases; in some cases driving pathology, and in others amplifying or exacerbating the inflammatory and damaging impact of non-complement disease triggers. The role of complement in pathogenesis of an expanding number of diseases has driven industry and academia alike to develop an impressive arsenal of anti-complement drugs which target different proteins and functions of the complement cascade. Evidence from genetic and biochemical analyses, combined with improved identification of complement biomarkers and supportive data from sophisticated animal models of disease, has driven a drug development landscape in which the indications selected for clinical trial cluster in three 'target' tissues: the kidney, eye and vasculature. While the disease triggers may differ, complement activation and amplification is a common feature in many diseases which affect these three tissues. An abundance of drugs are in clinical development, some show favourable progression whereas others experience significant challenges. However, these hurdles in themselves drive an ever-evolving portfolio of 'next-generation' drugs with improved pharmacokinetic and pharmacodynamics properties. In this review we discuss the indications which are in the drug development 'spotlight' and review the relevant indication validation criteria. We present current progress in clinical trials, highlighting successes and difficulties, and look forward to approval of a wide selection of drugs for use in man which give clinicians choice in mechanistic target, modality and route of delivery.
Collapse
Affiliation(s)
- Claire L Harris
- Complement Therapeutics Research Group, Institute of Cellular Medicine, Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK; National Renal Complement Therapeutics Centre, Building 26, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.
| | - Richard B Pouw
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, CH-4056, Basel, Switzerland
| | - David Kavanagh
- Complement Therapeutics Research Group, Institute of Cellular Medicine, Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK; National Renal Complement Therapeutics Centre, Building 26, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK
| | - Ruyue Sun
- Complement Therapeutics Research Group, Institute of Cellular Medicine, Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Daniel Ricklin
- Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, CH-4056, Basel, Switzerland.
| |
Collapse
|
9
|
Dumestre-Pérard C, Clavarino G, Colliard S, Cesbron JY, Thielens NM. Antibodies targeting circulating protective molecules in lupus nephritis: Interest as serological biomarkers. Autoimmun Rev 2018; 17:890-899. [PMID: 30009962 DOI: 10.1016/j.autrev.2018.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/15/2018] [Indexed: 12/15/2022]
Abstract
Lupus nephritis (LN) is one of the most frequent and severe manifestations of systemic lupus erythematosus (SLE), considered as the major predictor of poor prognosis. An early diagnosis of LN is a real challenge in the management of SLE and has an important implication in guiding treatments. In clinical practice, conventional parameters still lack sensitivity and specificity for detecting ongoing disease activity in lupus kidneys and early relapse of nephritis. LN is characterized by glomerular kidney injury, essentially due to deposition of immune complexes involving autoantibodies against cellular components and circulating proteins. One of the possible mechanisms of induction of autoantibodies in SLE is a defect in apoptotic cells clearance and subsequent release of intracellular autoantigens. Autoantibodies against soluble protective molecules involved in the uptake of dying cells, including complement proteins and pentraxins, have been described. In this review, we present the main autoantibodies found in LN, with a focus on the antibodies against these protective molecules. We also discuss their pathogenic role and conclude with their potential interest as serological biomarkers in LN.
Collapse
Affiliation(s)
- Chantal Dumestre-Pérard
- Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France; BNI TIMC-IMAG, UMR5525, CNRS-Université Grenoble Alpes, BP170, 38042 Grenoble Cedex 9, France.
| | - Giovanna Clavarino
- Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France; BNI TIMC-IMAG, UMR5525, CNRS-Université Grenoble Alpes, BP170, 38042 Grenoble Cedex 9, France
| | - Sophie Colliard
- Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France
| | - Jean-Yves Cesbron
- Laboratoire d'Immunologie, Pôle de Biologie, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France; BNI TIMC-IMAG, UMR5525, CNRS-Université Grenoble Alpes, BP170, 38042 Grenoble Cedex 9, France
| | | |
Collapse
|
10
|
Yao Q, Li J, An X, Jiang W, Qin Q, Song R, Yan N, Li D, Jiang Y, Wang W, Shi L, Zhang JA. Association between C1q gene polymorphisms and autoimmune thyroid diseases. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:337-342. [PMID: 28225862 PMCID: PMC10118932 DOI: 10.1590/2359-3997000000256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 10/18/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE In the present study, we aimed to assess the associations of C1q gene polymorphisms with autoimmune thyroid diseases (AITD) susceptibility. SUBJECTS AND METHODS A set of 1,003 AITD patients (661 with Graves' disease and 342 with Hashimoto's thyroiditis) and 880 ethnically- and geographically-matched controls from Chinese Han population were included. Five common single nucleotide polymorphisms (SNPs) (rs294185, rs292001, rs682658, rs665691 and rs294179) in C1q gene locus were genotyped. Frequencies of genotypes and alleles were compared between patients and controls, and haplotype analysis was also performed. RESULTS There was no statistically significant difference between AITD patients and controls in the frequencies of alleles of rs294185 (P = 0.41), rs292001 (P = 0.71), rs682658 (P = 0.68), rs665691 (P = 0.68) and rs294179 (P = 0.69). There was also no statistically significant difference between AITD patients and controls in the frequencies of genotypes of rs294185 (P = 0.72), rs292001 (P = 0.89), rs682658 (P = 0.83), rs665691 (P = 0.90) and rs294179 (P = 0.43). Stratified analyses showed that none of those five SNPs in C1q gene were associated with Graves' disease or Hashimoto's thyroiditis (all P values > 0.05). Haplotype analysis revealed that there were no obvious genetic associations of C1q gene polymorphisms with AITD susceptibility. CONCLUSIONS We, for the first time, identified the associations between C1q gene SNPs and AITD, and our findings suggested that five common SNPs in C1q gene were not associated with AITD susceptibility in Chinese Han population.
Collapse
Affiliation(s)
- Qiuming Yao
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Jie Li
- Department of Nephrology, Xi'an Central Hospital, Xi'an, China
| | - Xiaofei An
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Wenjuan Jiang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Qiu Qin
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Ronghua Song
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Ni Yan
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Danfeng Li
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Yanfei Jiang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Wen Wang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Liangfeng Shi
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Jin-An Zhang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| |
Collapse
|
11
|
Gheerbrant H, Giovannini D, Falque L, Andry F, Lugosi M, Deroux A. Vascularite hypocomplémentémique urticarienne associée à une glomérulonéphrite membrano-proliférative sévère et polyadénopathies. Presse Med 2017; 46:547-550. [DOI: 10.1016/j.lpm.2017.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 01/05/2017] [Indexed: 11/16/2022] Open
|
12
|
Suárez-Fueyo A, Bradley SJ, Klatzmann D, Tsokos GC. T cells and autoimmune kidney disease. Nat Rev Nephrol 2017; 13:329-343. [PMID: 28287110 DOI: 10.1038/nrneph.2017.34] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Glomerulonephritis is traditionally considered to result from the invasion of the kidney by autoantibodies and immune complexes from the circulation or following their formation in situ, and by cells of the innate and the adaptive immune system. The inflammatory response leads to the proliferation and dysfunction of cells of the glomerulus, and invasion of the interstitial space with immune cells, resulting in tubular cell malfunction and fibrosis. T cells are critical drivers of autoimmunity and related organ damage, by supporting B-cell differentiation and antibody production or by directly promoting inflammation and cytotoxicity against kidney resident cells. T cells might become activated by autoantigens in the periphery and become polarized to secrete inflammatory cytokines before entering the kidney where they have the opportunity to expand owing to the presence of costimulatory molecules and activating cytokines. Alternatively, naive T cells could enter the kidney where they become activated after encountering autoantigen and expand locally. As not all individuals with a peripheral autoimmune response to kidney antigens develop glomerulonephritis, the contribution of local kidney factors expressed or produced by kidney cells is probably of crucial importance. Improved understanding of the biochemistry and molecular biology of T cells in patients with glomerulonephritis offers unique opportunities for the recognition of treatment targets for autoimmune kidney disease.
Collapse
Affiliation(s)
- Abel Suárez-Fueyo
- Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, CLS-937, Boston, Massachusetts 02215, USA
| | - Sean J Bradley
- Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, CLS-937, Boston, Massachusetts 02215, USA
| | - David Klatzmann
- Sorbonne Universités, Pierre and Marie Curie University, INSERM UMR_S 959, 83 Boulevard de l'Hôpital, F-75013, Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Clinical Investigation Center in Biotherapy and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), 83 boulevard de l'Hôpital, F-75013, Paris, France
| | - George C Tsokos
- Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, CLS-937, Boston, Massachusetts 02215, USA
| |
Collapse
|
13
|
Devaraju P, Reni BN, Gulati R, Mehra S, Negi VS. Complement C1q and C2 polymorphisms are not risk factors for SLE in Indian Tamils. Immunobiology 2014; 219:465-8. [DOI: 10.1016/j.imbio.2014.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/13/2014] [Accepted: 02/16/2014] [Indexed: 01/26/2023]
|
14
|
Chu H, Wu LH, Song D, Yu F, Zhao MH. Noninflammatory necrotizing vasculopathy in lupus nephritis: a single-center experience. Lupus 2013; 23:20-30. [PMID: 24218394 DOI: 10.1177/0961203313512391] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In this study, we assessed the clinicopathological features of lupus nephritis patients with renal noninflammatory necrotizing vasculopathy (NNV). A total of 142 renal biopsies with lupus nephritis were reviewed, including nine cases presented with NNV and 36 without renal vascular lesions. The comparisons of clinical, laboratory and pathological features, treatments, as well as renal outcome between the two groups were further performed. In comparison with the no renal vascular lesions group, patients with NNV changes had significantly higher proportions of noninfection leukocyturia (p = 0.013) and leukocytopenia (p = 0.042), significantly higher serum creatinine (p = 0.012), lower hemoglobin (p = 0.002) and serum C3 (p < 0.001) levels. Renal pathological activity indices and chronicity indices were significantly higher in the NNV group (p = 0.002 and p = 0.006, respectively) than those in the no vascular lesions group. Regarding renal prognosis, the presence of NNV was not a risk factor for renal outcome (p = 0.327). In conclusion, NNV was not infrequent in renal biopsies of lupus nephritis. It was commonly associated with active clinical status and proliferative glomerular lesions of lupus.
Collapse
Affiliation(s)
- H Chu
- 1Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
| | | | | | | | | |
Collapse
|
15
|
Immunoserological parameters in SLE: high-avidity anti-dsDNA detected by ELISA are the most closely associated with the disease activity. Clin Rheumatol 2013; 32:1619-26. [DOI: 10.1007/s10067-013-2330-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 06/03/2013] [Accepted: 06/26/2013] [Indexed: 02/08/2023]
|
16
|
Trad B, Ben Hassine H, Khalifa M, Idriss N, Slama F, Bahri F, Laouani Kechrid C, Boukadida J, Sghiri R. Anti-C1q antibodies and systemic lupus erythematosus in the Tunisian population. ACTA ACUST UNITED AC 2013; 61:113-6. [PMID: 23399411 DOI: 10.1016/j.patbio.2013.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 01/09/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The presence of a wide variety of autoantibodies is a characteristic feature of systemic lupus erythematosus (SLE). Although non-specific, anti-complement C1q (anti-C1q) were shown to correlate with the occurrence of active nephritis. The present study aimed to investigate the prevalence of anti-C1q in Tunisian SLE patients and their association with clinical manifestations, especially renal involvement. PATIENTS AND METHODS IgG anti-C1q antibodies were assessed by Elisa in 98 SLE patients, 55 patients with rheumatoid arthritis (RA) and 65 healthy individuals (HI). RESULTS Anti-C1q were found in 53 (54.1%) patients with SLE, three (5%) patients with RA and six (9.3%) HI. Among the 65 patients with renal involvement, anti-C1q were present in 35 (53.8%) patients. There was no significant association between anti-C1q and renal or extrarenal manifestations. In addition, there was no correlation between anti-C1q titer and SLEDAI index. Anti-C1q were significantly associated with anti-nucleosome (P=0.001), anti-Sm (P=0.01) and a low C4 level (P=0.046). Concomitant presence of anti-C1q and anti-dsDNA antibodies was not associated with renal manifestations. CONCLUSION Our study shows that prevalence of anti-C1q was comparable with that previously reported in Caucasian populations. These antibodies were associated with a low C4 level. However, there was no association between anti-C1q and renal involvement or severity of nephritis.
Collapse
Affiliation(s)
- B Trad
- Laboratory of Microbiology-Immunology, Farhat Hached Hospital, Ibn Al Jazzar street, 4000 Sousse, Tunisia
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Interleukin-15 (IL-15) and anti-C1q antibodies as serum biomarkers for ectopic pregnancy and missed abortion. Clin Dev Immunol 2013; 2013:637513. [PMID: 23401701 PMCID: PMC3562602 DOI: 10.1155/2013/637513] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 11/25/2012] [Indexed: 11/17/2022]
Abstract
Given the present lack of clinically useful tests for the accurate diagnosis of ectopic pregnancy (EP), there is a need to select out those immunological factors measured in the maternal serum, as potential biomarkers. Our assumption was that C1q/anti-C1q antibody complexes and serum levels of interleukin-15 (IL-15) may play a role in differentiating abortions (MAs) and EPs and normal pregnancies. We assessed whether their measurement could set the diagnosis in a case control study at 6–8 weeks consisting of 60 women with failed early pregnancy (30 EPs, 30 MAs) and 33 women with intrauterine pregnancies. Normal pregnancies contain anti-C1q antibodies more frequently compared to women with failed pregnancies, the lowest levels being found in EPs, but this lacked statistical significance and anti-C1q could not serve as a marker. However EP pregnancies had elevated IL-15 levels that could statistically significantly differentiate them from MAs and IUPs. Furthermore, when assessing IL-15 for the clinically important differentiation between IUP and EP, we found at a cut-off of 16 pg/mL a negative predictive value of 99 with a sensitivity for diagnosing an EP of 92%. According to these results, serum IL-15 is a promising marker differentiating an MA from an EP.
Collapse
|
18
|
Stoyanova V, Tchorbadjieva M, Deliyska B, Vasilev V, Tsacheva I. Biochemical analysis of the epitope specificities of anti-C1q autoantibodies accompanying human lupus nephritis reveals them as a dynamic population in the course of the disease. Immunol Lett 2012; 148:69-76. [PMID: 22981967 DOI: 10.1016/j.imlet.2012.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 08/06/2012] [Accepted: 08/29/2012] [Indexed: 12/27/2022]
Abstract
We analyzed the epitope specificities of the polyclonal anti-C1q antibodies, present in human LN sera, searching to deduce the structural characteristics of C1q associated with its transition to an autoantigen. We screened 78 serum samples from LN patients distributed in three clinical groups - non-active, moderately active and severely active. We found three classes of C1q autoepitopes: (a) neo-epitopes, exposed upon immobilization due to conformational changes; (b) epitopes formed by sequences that are brought together by the conformation of the whole molecule; (c) cryptic epitopes that become exposed only after fragmentation of C1q. The latter suggest that the immunogen involved in the initiation of anti-C1q autoantibodies might be an extrinsic molecule that shares some degree of structural similarity to C1q. None of the tested epitope specificities was associated with active LN. We found a prevalence of anti-gC1q antibodies among the non-active LN patients suggesting that they might be the fraction of the polyclonal anti-C1q, preceding the initiation of autoimmunity to C1q, or alternatively, preceding LN flare.
Collapse
Affiliation(s)
- Vishnya Stoyanova
- Department of Biochemistry, Faculty of Biology, Sofia University, 8 Dragan Tsankov Str., 1164 Sofia, Bulgaria
| | | | | | | | | |
Collapse
|
19
|
Tahtouh M, Garçon-Bocquet A, Croq F, Vizioli J, Sautière PE, Van Camp C, Salzet M, Nagnan-le Meillour P, Pestel J, Lefebvre C. Interaction of HmC1q with leech microglial cells: involvement of C1qBP-related molecule in the induction of cell chemotaxis. J Neuroinflammation 2012; 9:37. [PMID: 22356764 PMCID: PMC3298539 DOI: 10.1186/1742-2094-9-37] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 02/22/2012] [Indexed: 01/24/2023] Open
Abstract
Background In invertebrates, the medicinal leech is considered to be an interesting and appropriate model to study neuroimmune mechanisms. Indeed, this non-vertebrate animal can restore normal function of its central nervous system (CNS) after injury. Microglia accumulation at the damage site has been shown to be required for axon sprouting and for efficient regeneration. We characterized HmC1q as a novel chemotactic factor for leech microglial cell recruitment. In mammals, a C1q-binding protein (C1qBP alias gC1qR), which interacts with the globular head of C1q, has been reported to participate in C1q-mediated chemotaxis of blood immune cells. In this study, we evaluated the chemotactic activities of a recombinant form of HmC1q and its interaction with a newly characterized leech C1qBP that acts as its potential ligand. Methods Recombinant HmC1q (rHmC1q) was produced in the yeast Pichia pastoris. Chemotaxis assays were performed to investigate rHmC1q-dependent microglia migration. The involvement of a C1qBP-related molecule in this chemotaxis mechanism was assessed by flow cytometry and with affinity purification experiments. The cellular localization of C1qBP mRNA and protein in leech was investigated using immunohistochemistry and in situ hybridization techniques. Results rHmC1q-stimulated microglia migrate in a dose-dependent manner. This rHmC1q-induced chemotaxis was reduced when cells were preincubated with either anti-HmC1q or anti-human C1qBP antibodies. A C1qBP-related molecule was characterized in leech microglia. Conclusions A previous study showed that recruitment of microglia is observed after HmC1q release at the cut end of axons. Here, we demonstrate that rHmC1q-dependent chemotaxis might be driven via a HmC1q-binding protein located on the microglial cell surface. Taken together, these results highlight the importance of the interaction between C1q and C1qBP in microglial activation leading to nerve repair in the medicinal leech.
Collapse
Affiliation(s)
- Muriel Tahtouh
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée - EA4550, Microglial activation group, Université Lille Nord de France, Université Lille 1, IFR 147, bâtiment SN3, 59655 Villeneuve d'Ascq, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Radanova M, Vasilev V, Deliyska B, Kishore U, Ikonomov V, Ivanova D. Anti-C1q autoantibodies specific against the globular domain of the C1qB-chain from patient with lupus nephritis inhibit C1q binding to IgG and CRP. Immunobiology 2011; 217:684-91. [PMID: 22209113 DOI: 10.1016/j.imbio.2011.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 06/29/2011] [Accepted: 11/22/2011] [Indexed: 01/27/2023]
Abstract
Lupus nephritis is one of the most severe manifestations of systemic lupus erythematosus. Higher titers of serum anti-C1q autoantibodies correlate with disease activity in patients with lupus nephritis. Anti-C1q autoantibodies have been shown to bind neo-epitopes within the collagen region of human C1q. In a preliminary study, we recently reported that the anti-C1q autoantibodies could also recognize epitopes within the globular domain (gC1q) of the C1q molecule. Here, 38 sera from patients with renal biopsy-proven lupus nephritis were screened for the presence of anti-gC1q autoantibodies, using recombinant globular head regions of individual A (ghA), B (ghB) and C (ghC) chains of human C1q. We isolated anti-gC1q autoantibodies from three selected patients. Human C1q was pre-incubated with increasing concentrations of the isolated anti-ghA, anti-ghB or anti-ghC autoantibodies and its binding to different C1q target molecules such as IgG and CRP was then evaluated. Anti-ghB, but not anti-ghA and anti-ghC autoantibodies, markedly inhibited C1q interaction with IgG as well as CRP. These results appear to suggest that the anti-ghB autoantibodies may partially induce acquired functional C1q deficiency and thus may interfere with the biological function of C1q.
Collapse
Affiliation(s)
- Maria Radanova
- Department of Biochemistry, Molecular Medicine and Nutrigenomics, Medical University - Varna, Varna, Bulgaria.
| | | | | | | | | | | |
Collapse
|
21
|
O’Flynn J, Flierman R, van der Pol P, Rops A, Satchell SC, Mathieson PW, van Kooten C, van der Vlag J, Berden JH, Daha MR. Nucleosomes and C1q bound to glomerular endothelial cells serve as targets for autoantibodies and determine complement activation. Mol Immunol 2011; 49:75-83. [DOI: 10.1016/j.molimm.2011.07.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 12/31/2022]
|
22
|
Katsumata Y, Miyake K, Kawaguchi Y, Okamoto Y, Kawamoto M, Gono T, Baba S, Hara M, Yamanaka H. Anti-C1q antibodies are associated with systemic lupus erythematosus global activity but not specifically with nephritis: A controlled study of 126 consecutive patients. ACTA ACUST UNITED AC 2011; 63:2436-44. [DOI: 10.1002/art.30401] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
23
|
Alba P, Bertolaccini ML, Khamashta MA. The use of laboratory methods in differential diagnosis and treatment of SLE and antiphospholipid syndrome. Expert Rev Clin Immunol 2010; 3:613-22. [PMID: 20477165 DOI: 10.1586/1744666x.3.4.613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The detection of autoantibodies has become an important component in the diagnosis and management of systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Their importance lies in the fact that they are not only markers of the disease and used as part of a diagnostic panel, but many of them also show correlation with disease activity. All antibody testing should be interpreted in the context of the clinical features. The antinuclear antibodies test is an effective screening assay in patients with clinical features of SLE. The combination of antinuclear antibodies test, dsDNA and ENA (Ro, La, Sm, RNP) antibodies help to establish the diagnosis of most patients with SLE. New antibodies, such as antinucleosomes and anti-C1q, appear to be useful for SLE diagnosis, monitoring disease activity and predicting renal flares, particularly in dsDNA-negative patients. Anticardiolipin antibodies and lupus anticoagulant are the tests most commonly used in the diagnosis of antiphospholipid syndrome. However, the use of anti-beta(2)-glycoprotein I as a routine diagnostic test remains controversial.
Collapse
Affiliation(s)
- Paula Alba
- Servicio de Reumatologìa Hospital Còrdoba, Unidad Hospitalaria Medicina Interna 3, Universidad Nacional de Còrdoba, Còrdoba, Repùblica Argentina.
| | | | | |
Collapse
|
24
|
|
25
|
Tsirogianni A, Pipi E, Soufleros K. Relevance of anti-C1q autoantibodies to lupus nephritis. Ann N Y Acad Sci 2009; 1173:243-51. [PMID: 19758158 DOI: 10.1111/j.1749-6632.2009.04750.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The first component of the classical pathway of the complement system (C1q) is considered to have a crucial role in the clearance of immune complexes (ICs) as well as in the removal of waste material originating from apoptotic cells. A prolonged exposure of C1q epitopes to the immune system could eventually lead to an autoimmune response against itself. Although autoantibodies against C1q are found in several diseases, their clinical interest originates from their strong association to active lupus nephritis (LN). Several studies indicate that anti-C1q autoantibodies could serve as a reliable serologic marker in the assessment of LN activity compared to other immunological tests. Additionally, it was suggested that anti-C1q autoantibodies could play a role in LN pathogenesis. Their potential pathogenic actions likely depend on genetic background, titers, Ig classes and subclasses, and specific epitopes of anti-C1q autoantibodies as well as C1q availability and allocation. It is still unclear which different types of anti-C1q autoantibodies dominate in each case and if their upregulation is pathogenic, an epiphenomenon of aberrant tissue damage, or compensatory to an uncontrolled immune response.
Collapse
Affiliation(s)
- Alexandra Tsirogianni
- Department of Immunology-Histocompatibility, Evangelismos General Hospital, Athens, Greece.
| | | | | |
Collapse
|
26
|
Sinico RA, Rimoldi L, Radice A, Bianchi L, Gallelli B, Moroni G. Anti-C1q autoantibodies in lupus nephritis. Ann N Y Acad Sci 2009; 1173:47-51. [PMID: 19758131 DOI: 10.1111/j.1749-6632.2009.04746.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Anti-C1q antibodies are found in a variety of diseases, in addition to systemic lupus erythematosus (SLE), and in 3-5% of normal individuals. In particular, anti-C1q antibodies are detected at a high titer in 100% of patients with hypocomplementemic urticarial vasculitis and in 30-48% of SLE patients. Their titer correlates with active renal disease with a sensitivity of 44-100% and a specificity of 70-92%. An increase in anti-C1q antibody titer has been suggested to be able to predict renal flares in lupus nephritis so that monitoring anti-C1q might be valuable for the clinical management of SLE patients as a noninvasive biological marker. Recently our group studied 228 patients affected by lupus nephritis and found that the association of anti-C1q, C3, and C4, in a multivariate analysis, provided the best prediction of renal flares, particularly in patients with focal and diffuse proliferative lupus nephritis and in the absence of antiphospholipid antibodies.
Collapse
Affiliation(s)
- Renato Alberto Sinico
- Clinical Immunology Unit, Azienda Ospedaliera, Ospedale San Carlo Borromeo, Milano, Italy.
| | | | | | | | | | | |
Collapse
|
27
|
Moura CG, Lima I, Barbosa L, Athanazio D, Reis E, Reis M, Burlingame RW, Santiago MB. Anti-C1q antibodies: association with nephritis and disease activity in systemic lupus erythematosus. J Clin Lab Anal 2009; 23:19-23. [PMID: 19140207 DOI: 10.1002/jcla.20280] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Anti-C1q antibodies have been described in systemic lupus erythematosus (SLE) as well as in other connective tissue diseases. They have been considered as a marker for disease activity and presence of nephritis. OBJECTIVE The aim of this study was to determine the prevalence of anti-C1q antibodies in Brazilian lupus patients as well as analyze their association with different clinical and serologic parameters. METHODS Sera from 81 SLE patients, based on the American College of Rheumatology (ACR) criteria, were collected from a lupus referral outpatient clinic in Salvador, Brazil. Antibodies to C1q were detected by an enzyme-linked immunoassay (ELISA) kit and antibodies to other cellular antigens identified by indirect immunofluorescence on HEp-2 cell substrate (ANA), or Crithidia luciliae (dsDNA), and to nucleosome by ELISA. A cutoff of 20 U was established for anti-C1q and anti nucleosome assays. RESULTS Anti-C1q antibodies were detected in 39.5% (32/81) of SLE sera. The presence of anti-C1q antibodies was associated with proteinuria (P=0.028) but not with other laboratory or clinical features, such as anti nucleosome or anti-dsDNA antibodies, hematuria, urinary casts or renal failure, leukopenia, pericarditis, pleuritis, malar rash, seizures, and psychosis. There was a positive correlation between the titers of anti-C1q antibodies and the systemic lupuis erythematosus disease activity index (SLEDAI) score (r=0.370; P=0.001). CONCLUSION This study in Brazilian SLE patients confirms previous findings of the association of anti-C1q antibodies with nephritis and disease activity.
Collapse
Affiliation(s)
- Carlos Geraldo Moura
- Hospital Santo Antônio, Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Bigler C, Schaller M, Perahud I, Osthoff M, Trendelenburg M. Autoantibodies against complement C1q specifically target C1q bound on early apoptotic cells. THE JOURNAL OF IMMUNOLOGY 2009; 183:3512-21. [PMID: 19648280 DOI: 10.4049/jimmunol.0803573] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Autoantibodies against complement C1q (anti-C1q) are frequently found in patients with systemic lupus erythematosus (SLE). They strongly correlate with the occurrence of severe lupus nephritis, suggesting a pathogenic role in SLE. Because anti-C1q are known to recognize a neoepitope on bound C1q, but not on fluid-phase C1q, the aim of this study was to clarify the origin of anti-C1q by determining the mechanism that renders C1q antigenic. We investigated anti-C1q from serum and purified total IgG of patients with SLE and hypocomplementemic urticarial vasculitis as well as two monoclonal human anti-C1q Fab from a SLE patient generated by phage display. Binding characteristics, such as their ability to recognize C1q bound on different classes of Igs, on immune complexes, and on cells undergoing apoptosis, were analyzed. Interestingly, anti-C1q did not bind to C1q bound on Igs or immune complexes. Neither did we observe specific binding of anti-C1q to C1q bound on late apoptotic/necrotic cells when compared with binding in the absence of C1q. However, as shown by FACS analysis and confocal microscopy, anti-C1q specifically targeted C1q bound on early apoptotic cells. Anti-C1q were found to specifically target C1q bound on cells undergoing apoptosis. Our observations suggest that early apoptotic cells are a major target of the autoimmune response in SLE and provide a direct link between human SLE, apoptosis, and C1q.
Collapse
Affiliation(s)
- Cornelia Bigler
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland.
| | | | | | | | | |
Collapse
|
29
|
Wang Z, Li H, Xu H, Yue XL, Cheng XQ, Hou WJ, Zhang YY, Chen DF. Beneficial effect of Bupleurum polysaccharides on autoimmune disease induced by Campylobacter jejuni in BALB/c mice. JOURNAL OF ETHNOPHARMACOLOGY 2009; 124:481-487. [PMID: 19467314 DOI: 10.1016/j.jep.2009.05.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 04/28/2009] [Accepted: 05/17/2009] [Indexed: 05/27/2023]
Abstract
AIM OF THE STUDY Radix Bupleuri, is one of the most frequently prescribed crude herbs in the prescriptions of traditional Chinese medicine for the treatment of inflammatory diseases and auto-immune diseases. This study was to determine whether the crude polysaccharides (BPs) isolated from the roots of Bupleurum smithii var. parvifolium, had beneficial effects on autoimmune disease. MATERIALS AND METHODS BALB/c mice were immunized with CJ-S(131) in Freund's complete adjuvant on day 0, and then boosted on day 14. BPs 15 or 30 mg kg(-1) day(-1), or prednisone 5 mg kg(-1) day(-1) was given to BALB/c mice intragastrically from day 0 to day 34. RESULTS Treatment with BPs 15 or 30 mg kg(-1) day(-1) for 35 days protected kidney from glomerular injury with reduced immunoglobulin deposition and lowered proteinuria. The increased production of serum autoantibodies and total immunoglobulin G (IgG) was also inhibited. BPs 30 mg kg(-1) day(-1) improved weight loss and spleen swelling when compared with vehicle-treated group. CONCLUSIONS These findings suggested that Bupleurum polysaccharides had a beneficial effect on systemic lupus erythematosus-like syndroma induced by CJ-S(131) in BALB/c mice.
Collapse
Affiliation(s)
- Zheng Wang
- Department of Pharmacology, School of Pharmacy, Fudan University, Shanghai 200032, China
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Meyer OC, Nicaise-Roland P, Cadoudal N, Grootenboer-Mignot S, Palazzo E, Hayem G, Dieudé P, Chollet-Martin S. Anti-C1q antibodies antedate patent active glomerulonephritis in patients with systemic lupus erythematosus. Arthritis Res Ther 2009; 11:R87. [PMID: 19515233 PMCID: PMC2714141 DOI: 10.1186/ar2725] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Revised: 06/05/2009] [Accepted: 06/10/2009] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Autoantibodies against C1q correlate with lupus nephritis. We compared titers of anti-C1q and anti-dsDNA in 70 systemic lupus erythematosus patients with (n = 15) or without (n = 55) subsequent biopsy-proven lupus nephritis. METHODS The 15 patients with subsequent lupus nephritis had anti-C1q assays during clinical flares (mean Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), 10.0 +/- 4.7; range, 3 to 22) before the diagnosis of lupus nephritis (median, 24 months; range 3 to 192). Among the 55 others, 33 patients had active lupus (mean SLEDAI, 10.3 +/- 6.2; range, 4 to 30) without renal disease during follow-up (median 13 years; range 2 to 17 years) and 22 had inactive lupus (mean SLEDAI, 0; range, 0 to 3). RESULTS Anti-C1q titers were elevated in 15/15 (100%) patients who subsequently developed nephritis (class IV, n = 14; class V, n = 1) and in 15/33 (45%) patients without renal disease (P < 0.001). The median anti-C1q titer differed significantly between the groups (P = 0.003). Anti-C1q titers were persistently positive at the time of glomerulonephritis diagnosis in 70% (7/10) of patients, with no difference in titers compared with pre-nephritis values (median, 147 U/ml; interquartile range (IQR), 69 to 213 versus 116 U/ml; 50 to 284, respectively). Titers decreased after 6 months' treatment with immunosuppressive drugs and corticosteroids (median, 76 U/ml; IQR, 33 to 106) but remained above normal in 6/8 (75%) patients. Anti-dsDNA antibodies were increased in 14/15 (93.3%) patients with subsequent nephritis and 24/33 (72.7%) patients without nephritis (P = ns). Anti-C1q did not correlate with anti-dsDNA or the SLEDAI in either group. CONCLUSIONS Anti-C1q elevation had 50% positive predictive value (15/30) and 100% (18/18) negative predictive value for subsequent class IV or V lupus nephritis.
Collapse
Affiliation(s)
- Olivier C Meyer
- Rheumatology Unit, Bichat Hospital, APHP, 75018 Paris, France.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Mii A, Shimizu A, Masuda Y, Fujita E, Aki K, Ishizaki M, Sato S, Griesemer A, Fukuda Y. Current status and issues of C1q nephropathy. Clin Exp Nephrol 2009; 13:263-274. [PMID: 19373520 DOI: 10.1007/s10157-009-0159-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Accepted: 01/18/2009] [Indexed: 01/27/2023]
Abstract
C1q nephropathy, first proposed by Jennette and Hipp [Am J Clin Pathol 83:415-420, 1985; Am J Kidney Dis 6:103-110, 1985], was described as a distinct glomerular disease entity characterized by extensive mesangial deposition of C1q, with associated mesangial immune complexes, and the absence of any clinical and laboratory evidence of systemic lupus erythematosus. Now, 20 years since the first report, the disease entity is gradually attaining recognition, particularly in the field of pediatrics. C1q is the subcomponent of C1 in the classical pathway of complement activation. Generally, C1q deposition is caused by the activation of C1 by immunoglobulin G (IgG) and IgM; therefore, C1q nephropathy is considered as an immune complex glomerulonephritis. However, in C1q nephropathy, it remains unclear whether the deposition of C1q in the glomeruli is in response to the deposition of immunoglobulin or immune complex, or whether deposition is non-specific trapping that accompanies increased glomerular protein trafficking associated with proteinuria. Since not only the pathogenesis of C1q deposition in glomeruli but also its significance are still uncertain, it has not yet been established as an independent disease. From recent publications of the clinical and pathological characterizations, C1q nephropathy has been thought to be a subgroup of primary focal segmental glomerular sclerosis. However, many reports describe different symptoms, histopathologies, therapeutic responses and prognoses, suggesting that C1q nephropathy is not a single disease entity, but that it may be a combination of several disease groups. There are many uncertain areas requiring further investigation, though it is hoped that a detailed examination of future cases will clarify the subgroups making up C1q nephropathy and their clinicopathological characteristics, and will lead to the establishment of C1q nephropathy as an independent disease entity.
Collapse
Affiliation(s)
- Akiko Mii
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan.
| | - Yukinari Masuda
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| | - Emiko Fujita
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| | - Kaoru Aki
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| | - Masamichi Ishizaki
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| | - Shigeru Sato
- Central Institute for Electron Microscopic Researches, Nippon Medical School, Tokyo, Japan
| | - Adam Griesemer
- Transplantation Biology Research Center, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Yuh Fukuda
- Department of Analytic Human Pathology, Nippon Medical School, 1-25-2 Nezu, Bunkyo-ku, Tokyo, 113-0031, Japan
| |
Collapse
|
32
|
Seshan SV, Jennette JC. Renal disease in systemic lupus erythematosus with emphasis on classification of lupus glomerulonephritis: advances and implications. Arch Pathol Lab Med 2009; 133:233-48. [PMID: 19195967 DOI: 10.5858/133.2.233] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2008] [Indexed: 11/06/2022]
Abstract
CONTEXT Systemic lupus erythematosus is an autoimmune disease with protean clinical and pathologic manifestations involving almost all organs in the body. There is a high incidence of renal involvement during the course of the disease, with varied renal pathologic lesions and diverse clinical features. A renal biopsy examined by routine light microscopy, immunofluorescence, and electron microscopy contributes toward diagnosis, prognostic information, and appropriate management. OBJECTIVES (1) To review the clinical and various pathologic features of renal lesions in systemic lupus erythematosus patients. (2) To introduce the International Society of Nephrology and Renal Pathology Society Classification of Lupus Glomerulonephritis. DATA SOURCES A literature review, illustrations with original artwork, and tabulation of clinical and pathologic data of cases obtained from the authors' renal biopsy files examined during the last 8 years were used. CONCLUSIONS The International Society of Nephrology/ Renal Pathology Society-sponsored Classification of Lupus Glomerulonephritis proposes standardized definitions of the various pathologic findings, describes clinically relevant lesions, incorporates prognostic parameters, and recommends a uniform way of reporting the renal biopsy findings. Lupus glomerulonephritis is divided into 6 classes primarily based on the morphologic lesions, extent and severity of the involvement, immune complex deposition, and activity and chronicity. Special emphasis is laid on describing qualitative as well as quantitative morphologic data and to include the accompanying tubulointerstitial disease and different vascular lesions, which have prognostic and therapeutic significance. This classification is intended to facilitate a higher degree of reproducibility, resulting in better patient care and more effective future clinical and translational research. Renal biopsy findings in systemic lupus erythematosus add new and independent parameters of prognostic significance to established clinical and genetic factors.
Collapse
Affiliation(s)
- Surya V Seshan
- Department of Pathology and Laboratory Medicine,Weill Cornell Medical College, New York-Presbyterian Hospital, 525 E 68th Street, New York, NY 10065, USA.
| | | |
Collapse
|
33
|
Tahtouh M, Croq F, Vizioli J, Sautiere PE, Van Camp C, Salzet M, Daha MR, Pestel J, Lefebvre C. Evidence for a novel chemotactic C1q domain-containing factor in the leech nerve cord. Mol Immunol 2009; 46:523-31. [DOI: 10.1016/j.molimm.2008.07.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 07/15/2008] [Accepted: 07/15/2008] [Indexed: 10/21/2022]
|
34
|
Balsam L, Karim M, Miller F, Rubinstein S. Crescentic Glomerulonephritis Associated With Hypocomplementemic Urticarial Vasculitis Syndrome. Am J Kidney Dis 2008; 52:1168-73. [DOI: 10.1053/j.ajkd.2008.07.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 07/08/2008] [Indexed: 11/11/2022]
|
35
|
Kozyro I, Korosteleva L, Chernoshej D, Danner D, Sukalo A, Trendelenburg M. Autoantibodies against complement C1q in acute post-streptococcal glomerulonephritis. Clin Immunol 2008; 128:409-14. [DOI: 10.1016/j.clim.2008.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 04/18/2008] [Accepted: 04/18/2008] [Indexed: 10/22/2022]
|
36
|
Fang QY, Yu F, Tan Y, Xu LX, Wu LH, Liu G, Shao FM, Zhao MH. Anti-C1q antibodies and IgG subclass distribution in sera from Chinese patients with lupus nephritis. Nephrol Dial Transplant 2008; 24:172-8. [DOI: 10.1093/ndt/gfn453] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
37
|
Bigler C, Lopez-Trascasa M, Potlukova E, Moll S, Danner D, Schaller M, Trendelenburg M. Antinucleosome antibodies as a marker of active proliferative lupus nephritis. Am J Kidney Dis 2008; 51:624-9. [PMID: 18371538 DOI: 10.1053/j.ajkd.2007.10.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2007] [Accepted: 10/30/2007] [Indexed: 11/11/2022]
Abstract
BACKGROUND Antinucleosome autoantibodies were previously described to be a marker of active lupus nephritis. However, the true prevalence of antinucleosome antibodies at the time of active proliferative lupus nephritis has not been well established. Therefore, the aim of this study is to define the prevalence and diagnostic value of autoantibodies against nucleosomes as a marker for active proliferative lupus nephritis. STUDY DESIGN Prospective multicenter diagnostic test study. SETTING & PARTICIPANTS 35 adult patients with systemic lupus erythematosus (SLE) at the time of the renal biopsy showing active class III or IV lupus nephritis compared with 59 control patients with SLE. INDEX TEST Levels of antinucleosome antibodies and anti-double-stranded DNA (anti-dsDNA) antibodies. REFERENCE TEST Kidney biopsy findings of class III or IV lupus nephritis at the time of sampling in a study population versus clinically inactive or no nephritis in a control population. RESULTS Increased concentrations of antinucleosome antibodies were found in 31 of 35 patients (89%) with active proliferative lupus nephritis compared with 47 of 59 control patients (80%) with SLE. No significant difference between the 2 groups with regard to number of positive patients (P = 0.2) or antibody concentrations (P = 0.2) could be found. The area under the receiver operating characteristic curve as a marker of the accuracy of the test in discriminating between proliferative lupus nephritis and inactive/no nephritis in patients with SLE was 0.581 (95% confidence interval, 0.47 to 0.70; P = 0.2). Increased concentrations of anti-dsDNA antibodies were found in 33 of 35 patients (94.3%) with active proliferative lupus nephritis compared with 49 of 58 control patients (84.5%) with SLE (P = 0.2). In patients with proliferative lupus nephritis, significantly higher titers of anti-dsDNA antibodies were detected compared with control patients with SLE (P < 0.001). The area under the receiver operating characteristic curve in discriminating between proliferative lupus nephritis and inactive/no nephritis in patients with SLE was 0.710 (95% confidence interval, 0.60 to 0.82; P < 0.001). CONCLUSIONS Antinucleosome antibodies have a high prevalence in patients with severe lupus nephritis. However, our data suggest that determining antinucleosome antibodies is of limited help in the distinction of patients with active proliferative lupus nephritis from patients with SLE without active renal disease.
Collapse
Affiliation(s)
- Cornelia Bigler
- Clinical Immunology Laboratory, University Hospital Basel, Basel, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
38
|
Potlukova E, Jiskra J, Limanova Z, Kralikova P, Smutek D, Mareckova H, Antosova M, Trendelenburg M. Autoantibodies against complement C1q correlate with the thyroid function in patients with autoimmune thyroid disease. Clin Exp Immunol 2008; 153:96-101. [PMID: 18505435 DOI: 10.1111/j.1365-2249.2008.03670.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Autoantibodies against complement C1q (anti-C1q) have been well described in patients with systemic lupus erythematosus, where they correlate with the occurrence of severe lupus nephritis. However, data on anti-C1q in organ-specific autoimmune diseases are scarce. In order to determine the prevalence of anti-C1q in patients with autoimmune thyroid disorders (AITD) and a possible association with thyroid function, we measured prospectively anti-C1q in 23 patients with Graves' disease (GD) and 52 patients with Hashimoto's thyroiditis (HT). Anti-C1q levels were correlated with parameters of thyroid function and autoantibodies against thyroperoxidase, thyroglobulin and thyroid stimulating hormone (TSH) receptor. Twenty-one patients with multi-nodular goitre and 72 normal blood donors served as controls. We found elevated concentrations of anti-C1q more frequently in patients with AITD than in controls: seven of 23 (30%) patients with GD and 11 of 52 (21%) patients with HT, compared with one of 21 (5%) patients with multi-nodular goitre and six of 72 (8%) normal controls. Anti-C1q levels did not correlate with thyroid autoantibodies. However, in GD absolute levels of anti-C1q correlated negatively with TSH and positively with free thyroxine (FT4) and triiodothyronine (FT3). In contrast, in HT, anti-C1q correlated positively with TSH levels. No correlation between TSH and thyroid autoantibodies was found. In conclusion, we found an increased prevalence of anti-C1q in patients with AITD and their levels correlated with the thyroid function in both GD and HT. This correlation seems to be independent of thyroid autoantibodies. Therefore, anti-C1q might point to a pathogenic mechanism involved in the development of AITD that is independent of classical thyroid autoantibodies.
Collapse
Affiliation(s)
- E Potlukova
- 3rd Clinic of Medicine, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Flierman R, Daha MR. The clearance of apoptotic cells by complement. Immunobiology 2006; 212:363-70. [PMID: 17544821 DOI: 10.1016/j.imbio.2006.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2006] [Revised: 11/06/2006] [Accepted: 11/09/2006] [Indexed: 12/16/2022]
Abstract
The complement system is implicated among others in the clearance of apoptotic cells, and deficiency for different components of the complement system is associated with aberrant handling of apoptotic material. As a result of this, it is thought that the complement system is involved in the pathogenesis of autoimmune diseases such as systemic lupus erythematosus (SLE) which affects multiple organs. In this review, the authors highlight the available data on complement and apoptosis, as well as the role of complement in severe autoimmune diseases like SLE.
Collapse
Affiliation(s)
- Roelof Flierman
- Leiden University Medical Center, Department of Nephrology, Leiden, The Netherlands.
| | | |
Collapse
|