Suppr
超能文献

抗C反应蛋白自身抗体：系统性红斑狼疮和原发性抗磷脂综合征中的临床关联

Autoantibodies against C-reactive protein: clinical associations in systemic lupus erythematosus and primary antiphospholipid syndrome.

作者信息

Figueredo Maria A, Rodriguez Antonia, Ruiz-Yagüe Margarita, Romero Marta, Fernandez-Cruz Arturo, Gomez-de la Concha Emilio, Patiño Ramon

机构信息

Services of Immunology and Internal Medicine III, Hospital Clìnico de San Carlos, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

J Rheumatol. 2006 Oct;33(10):1980-6.

PMID:17014014

Abstract

OBJECTIVE

To investigate the prevalence of anti-C-reactive protein (CRP) autoantibodies in patients with systemic lupus erythematosus (SLE) and non-SLE patients with persistent antiphospholipid antibodies (aPL) and their association with clinical manifestations.

METHODS

Sera of 137 patients with SLE, 127 with persistent aPL and 30 with idiopathic venous thromboembolic disease, were assayed for the presence of anti-CRP reactivity by ELISA. Associations of anti-CRP reactivity with clinical features, with other autoantibodies, and with serum concentrations of C3 and CRP were assessed.

RESULTS

Antibodies against CRP were seen in 51% (n = 137) of patients with SLE and in 54% (n = 127) of patients with aPL. SLE patients with anti-CRP antibodies showed increased frequencies of anti-dsDNA and aPL antibodies compared to those without anti-CRP (52% vs 26% and 68% vs 31%, respectively). Mean serum C3 levels were lower in the subgroup of patients with SLE positive for anti-CRP antibodies (79 +/- 25 vs 92 +/- 25 mg/dl; p = 0.004 ) and mean serum CRP levels were significantly higher (13 +/- 17 vs 5 +/- 8 mg/l; p = 0.01 ). The frequency of nephritis was higher in SLE patients with anti-CRP antibodies, than in those without (27% vs 13%; p = 0.058). In patients with clinical and serological evidence of antiphospholipid syndrome (APS) the frequency of anti-CRP antibodies was significantly higher than in asymptomatic aPL carriers, in both SLE patients [85% (23 of 27) vs 59% (19 of 32); p = 0.021] and non-SLE patients [76% (38 of 50) vs 19% (9 of 47); p < 0.001]. Among patients with APS with or without SLE, 26 had arterial events, 31 had venous events, 6 had combined arterial and venous events, and 14 had fetal loss. Mean titers of IgG anti-CRP (29 +/- 21, 30 +/- 19, 60 +/- 37, and 26 +/- 12 AU/ml) and frequencies of anti-CRP antibodies (88%, 71%, 50%, and 71%) in these subgroups of patients were comparable.

CONCLUSION

We confirmed the high prevalence of anti-CRP autoantibodies both in patients with SLE and in non-SLE and aPL-positive patients. We observed that the presence of these antibodies was associated with lupus nephritis and with clinical features of the APS in patients with lupus and non-lupus patients.

摘要

目的

研究系统性红斑狼疮（SLE）患者及伴有持续性抗磷脂抗体（aPL）的非SLE患者中抗C反应蛋白（CRP）自身抗体的患病率及其与临床表现的关系。

方法

采用酶联免疫吸附测定（ELISA）法检测137例SLE患者、127例伴有持续性aPL的患者及30例特发性静脉血栓栓塞性疾病患者血清中的抗CRP反应性。评估抗CRP反应性与临床特征、其他自身抗体以及血清C3和CRP浓度之间的关联。

结果

51%（n = 137）的SLE患者及54%（n = 127）的aPL患者检测到抗CRP抗体。与无抗CRP抗体的SLE患者相比，有抗CRP抗体的SLE患者抗双链DNA和aPL抗体的频率增加（分别为52%对26%和68%对31%）。抗CRP抗体阳性的SLE患者亚组的平均血清C3水平较低（79±25对92±25mg/dl；p = 0.004），平均血清CRP水平显著更高（13±17对5±8mg/l；p = 0.01）。有抗CRP抗体的SLE患者肾炎的发生率高于无抗CRP抗体的患者（27%对13%；p = 0.058）。在有抗磷脂综合征（APS）临床和血清学证据的患者中，抗CRP抗体的频率在SLE患者[85%（27例中的23例）对59%（32例中的19例）；p = 0.021]和非SLE患者[76%（50例中的38例）对19%（47例中的9例）；p < 0.001]中均显著高于无症状aPL携带者。在有或无SLE的APS患者中，26例发生动脉事件，31例发生静脉事件，6例发生动静脉联合事件，14例发生胎儿丢失。这些患者亚组中IgG抗CRP的平均滴度（29±21、30±19、60±37和26±12AU/ml）和抗CRP抗体的频率（88%、71%、50%和71%）相当。