Department of Rheumatology and Clinical Immunology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
J Rheumatol. 2010 Apr;37(4):759-65. doi: 10.3899/jrheum.090779. Epub 2010 Mar 1.
To investigate the relationship between serum anti-C1q antibody levels and renal pathological characteristics in lupus nephritis as well as the prognostic significance of serum anti-C1q antibody.
Seventy-three patients with biopsy-proven lupus nephritis were enrolled. Anti-C1q antibody was measured in serum samples taken within 7 days before renal biopsy and remeasured at the end of the first and the third month after treatment. All patients were followed at least once a month for 3 months. A cross-sectional study analyzed the relationship between serum anti-C1q antibody levels and renal histopathology and nephritic activity, while a longitudinal study evaluated the prognostic significance of anti-C1q antibody levels in lupus nephritis.
Fifty-eight of 73 patients (79.5%) were reported as having positive baseline serum anti-C1q antibody, with a mean level of 95.3 (+/- 55.2) U/ml. Significant differences were found in serum anti-C1q antibody levels between each World Health Organization (WHO) classification of lupus nephritis. The serum anti-C1q antibody level of WHO class IV was the highest. Serum anti-C1q antibody was positively correlated with the active and chronic indices in renal pathology. Patients with persistent high levels or increased titers of serum anti-C1q antibody tended to develop delayed remission in nephropathy. Serum anti-C1q antibody levels before and after treatment were relevant to renal remission, but serum anti-C1q antibody at the end of the third month after treatment was a stronger predictor for the prognosis after adjustment in the Cox's proportional hazards regression model.
Serum anti-C1q antibody is a valuable noninvasive biological marker for evaluation of renal involvement and lupus prognosis.
探讨狼疮肾炎患者血清抗 C1q 抗体水平与肾脏病理特征的关系及血清抗 C1q 抗体的预后意义。
纳入 73 例经肾活检证实的狼疮肾炎患者，在肾活检前 7 天内采集血清样本检测抗 C1q 抗体，并在治疗后第 1 个月和第 3 个月末进行复测。所有患者至少每月随访 1 次，随访 3 个月。横断面研究分析血清抗 C1q 抗体水平与肾脏组织病理学和肾炎活动度的关系，纵向研究评估抗 C1q 抗体水平在狼疮肾炎中的预后意义。
73 例患者中 58 例（79.5%）报告基线血清抗 C1q 抗体阳性，平均水平为 95.3（+/-55.2）U/ml。不同 WHO 狼疮肾炎分类之间血清抗 C1q 抗体水平存在显著差异，WHO Ⅳ类的血清抗 C1q 抗体水平最高。血清抗 C1q 抗体与肾脏病理的活动和慢性指数呈正相关。持续高或升高的血清抗 C1q 抗体水平的患者发生肾病缓解延迟的趋势。治疗前后的血清抗 C1q 抗体水平与肾脏缓解相关，但在 Cox 比例风险回归模型校正后，治疗后第 3 个月的血清抗 C1q 抗体水平是预后的更强预测因子。
血清抗 C1q 抗体是评估肾脏受累和狼疮预后的有价值的非侵入性生物标志物。
