Sinico Renato Alberto, Radice Antonella, Ikehata Masami, Giammarresi Gaia, Corace Caterina, Arrigo Girolamo, Bollini Bruna, Li Vecchi Maurizio
Dipartimento di Nefrologia e Immunologia, Azienda Ospedaliera, Ospedale San Carlo Borromeo, Via Pio Secondo 3, 20153 Milano, Italy.
Ann N Y Acad Sci. 2005 Jun;1050:193-200. doi: 10.1196/annals.1313.020.
Recently, anti-C1q autoantibodies have been proposed as a useful marker in systemic lupus erythematosus (SLE) since their occurrence correlates with renal involvement and, possibly, with nephritic activity. We aimed to evaluate the prevalence of anti-C1q antibodies in patients with SLE, with and without renal involvement, and to correlate these markers' presence and levels with the activity of the disease and nephropathy. We studied 61 patients with SLE, 40 of whom had biopsy-proven lupus nephritis; 35 patients with other connective tissue diseases; and 54 healthy controls. In addition, 18 lupus nephritis patients were followed up during the disease time course. Anti-C1q antibodies were measured using "homemade" ELISA with high salt concentration (1 M sodium chloride). High anti-C1q antibody titers (> 55 AU) were present in 27 of 61 (44%) SLE patients and in 4% and 0% of normal blood donors and pathologic controls, respectively. Anti-C1q antibodies were found in 60% of patients with lupus nephritis compared with only 14% of SLE patients without nephropathy (P < 0.05). Moreover, patients who were positive for anti-C1q antibodies had a higher European Consensus Lupus Activity Measurement (ECLAM) score (4.35 vs. 2.2); 89% of patients with active lupus nephritis showed high titers of anti-C1q antibodies compared with 0% of patients with inactive nephritis. Anti-C1q and anti-dsDNA antibodies agreed in 79% of cases. Our results confirm that anti-C1q antibodies are present in a significant percentage of SLE patients, and that their presence and levels correlate with disease activity-in particular, during renal flare-ups.
最近，抗C1q自身抗体被认为是系统性红斑狼疮（SLE）的一个有用标志物，因为其出现与肾脏受累相关，可能还与肾炎活动有关。我们旨在评估有和没有肾脏受累的SLE患者中抗C1q抗体的患病率，并将这些标志物的存在和水平与疾病及肾病的活动相关联。我们研究了61例SLE患者，其中40例经活检证实为狼疮性肾炎；35例其他结缔组织病患者；以及54名健康对照者。此外，对18例狼疮性肾炎患者在疾病病程中进行了随访。使用高盐浓度（1M氯化钠）的“自制”ELISA法检测抗C1q抗体。61例（44%）SLE患者中有27例抗C1q抗体滴度高（>55 AU），正常献血者和病理对照者中这一比例分别为4%和0%。狼疮性肾炎患者中有60%发现抗C1q抗体，而无肾病的SLE患者中只有14%发现该抗体（P<0.05）。此外，抗C1q抗体阳性的患者欧洲狼疮活动度共识测量（ECLAM）评分更高（4.35比2.2）；89%的活动性狼疮性肾炎患者抗C1q抗体滴度高，而无活动性肾炎的患者这一比例为0%。抗C1q和抗双链DNA抗体在79%的病例中结果一致。我们的结果证实，相当比例的SLE患者存在抗C1q抗体，其存在和水平与疾病活动相关，尤其是在肾脏病情发作期间。
