Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taiwan.
Lupus. 2011 Nov;20(13):1404-10. doi: 10.1177/0961203311417033. Epub 2011 Sep 26.
The objective of this study is to evaluate the correlation between antinucleosome antibodies and renal pathological activity in patients with proliferative lupus nephritis (LN). We evaluated 36 patients with proliferative LN, 14 non-renal lupus patients and 10 healthy volunteers. Lupus activity was assessed using the British Isles Lupus Assessment Group 2004 (BILAG 2004) index, serum anti-double stranded DNA (anti-dsDNA) levels, serum complement levels and daily urinary protein levels. All 36 lupus nephritis patients received renal biopsy. Antinucleosome antibodies were detected by enzyme-linked immunosorbent assay (ELISA). Our results showed that levels of serum antinucleosome antibodies were significantly higher in LN patients (median 90.35 units/ml, interquartile range [IQR] 37.38-135.23) than in non-renal SLE patients (median 5.45 units/ml, IQR 2.6-28.93, p <0.05) and in healthy volunteers (median 3.35 units/ml, IQR 2.95-5.23, p <0.001). Serum levels of antinucleosome antibodies were positively correlated with BILAG index (Spearman's r = 0.645, p <0.001) and serum anti-dsDNA antibody levels (r(s) = 0.644, p <0.01), while serum levels of antinucleosome antibodies were negatively correlated with serum levels of C3 (r(s) = -0.400, p <0.01) and C4 (r(s) = -0.300, p <0.05). Serum levels of antinucleosome antibodies were positively correlated with the histological activity index of LN (r(s) = 0.368, p <0.05). However, there was no significant correlation between serum levels of antinucleosome antibodies and the histological chronicity index. In conclusion, the serum level of antinucleosome antibodies is a potential biomarker for early recognition of renal involvement and evaluation of disease activity in SLE. Our preliminary results suggested that serum levels of antinucleosome antibodies might be a potential biomarker in evaluating pathological activity of LN.
本研究旨在评估抗核小体抗体与增生性狼疮肾炎（LN）患者肾病理活动之间的相关性。我们评估了 36 例增生性 LN 患者、14 例非肾狼疮患者和 10 名健康志愿者。狼疮活动采用英国狼疮评估组 2004 年（BILAG 2004）指数、血清抗双链 DNA（抗 dsDNA）水平、血清补体水平和每日尿蛋白水平进行评估。所有 36 例狼疮肾炎患者均接受肾活检。抗核小体抗体采用酶联免疫吸附试验（ELISA）检测。结果显示，LN 患者血清抗核小体抗体水平明显高于非肾 SLE 患者（中位数 90.35 单位/ml，四分位距 [IQR] 37.38-135.23）和健康志愿者（中位数 3.35 单位/ml，IQR 2.95-5.23，p<0.05）。血清抗核小体抗体水平与 BILAG 指数呈正相关（Spearman's r=0.645，p<0.001）和血清抗 dsDNA 抗体水平（r(s)=0.644，p<0.01），而血清抗核小体抗体水平与血清补体 C3（r(s)=-0.400，p<0.01）和 C4（r(s)=-0.300，p<0.05）呈负相关。血清抗核小体抗体水平与 LN 的组织学活动指数呈正相关（r(s)=0.368，p<0.05）。然而，血清抗核小体抗体水平与组织学慢性指数无显著相关性。总之，血清抗核小体抗体水平是早期识别肾受累和评估 SLE 疾病活动的潜在生物标志物。我们的初步结果表明，血清抗核小体抗体水平可能是评估 LN 病理活动的潜在生物标志物。
