López-Longo F J, López-Gómez J M, Jofre Ibáñez R, Escalona M, Rodríguez-Mahou M
Servicio de Reumatología, Hospital General Gregorio, Marañón, Madrid.
Rev Clin Esp. 1992 Nov;191(7):354-9.
With the aim to analyze the prognostic value of anti-RNP/Sm and anti-Ro/La antibodies (Ab) in lupus nephropathy, we have studied through Contraimmunoelectrophoresis (CIE) and Immunoblotting (IB) the serum of 63 patients diagnosed of systemic lupus erythematosus. Mean age was 36.5 years (15-71) and 90% were females. We have classified the patients into three subgroups: I, 25 patients without nephropathy; II, 26 patients with evidence of nephropathy (persistent proteinuria and/or microhematuria) and normal renal function; and III, 12 patients with renal failure (servu creatinine > 1.5 mg/dl). 21 patients had kidney biopsy. IB allows to identify a higher number of positive serum, specially in the case of anti-RNP (7.9% CIE vs 28.5% IB) and anti-Sm antibodies (6.3% vs 30.1%). Prevalence of anti-RNP Ab is lower in subgroup III (32% I vs 34% II vs 8% III) (p > 0.05). Anti-Sm Ab are more frequent in group II and are not associated with renal failure (16% vs 54% vs 8%) (p > 0.05). Anti-Ro Ab are related with the absence of nephropathy (52% vs 15% vs 0%) (p < 0.05). We conclude that IB is more sensitive than CIE in the detection of these Ab and its use in Systemic Lupus Erythematosus permits to identify patient subgroups with lesser risk to develop renal failure. Even though our data are preliminary, we suggest that the detection of anti-RNP/Sm and/or anti-Ro/La antibodies are a good prognostic factor in lupus nephropathy.
为分析抗RNP/Sm和抗Ro/La抗体（Ab）在狼疮性肾炎中的预后价值，我们通过对流免疫电泳（CIE）和免疫印迹法（IB）研究了63例诊断为系统性红斑狼疮患者的血清。平均年龄为36.5岁（15 - 71岁），90%为女性。我们将患者分为三个亚组：I组，25例无肾病患者；II组，26例有肾病证据（持续性蛋白尿和/或镜下血尿）且肾功能正常的患者；III组，12例肾衰竭患者（血清肌酐>1.5mg/dl）。21例患者进行了肾活检。IB能检测出更多阳性血清，特别是抗RNP（CIE为7.9%，IB为28.5%）和抗Sm抗体（分别为6.3%和30.1%）的情况。抗RNP Ab在III组中的患病率较低（I组为32%，II组为34%，III组为8%）（p>0.05）。抗Sm Ab在II组中更常见，且与肾衰竭无关（分别为16%、54%和8%）（p>0.05）。抗Ro Ab与无肾病相关（分别为52%、15%和0%）（p<0.05）。我们得出结论，在检测这些抗体方面，IB比CIE更敏感，在系统性红斑狼疮中使用它有助于识别发生肾衰竭风险较低的患者亚组。尽管我们的数据是初步的，但我们认为检测抗RNP/Sm和/或抗Ro/La抗体是狼疮性肾炎的一个良好预后因素。
