Jourde-Chiche Noémie, Daniel Laurent, Chiche Laurent, Burtey Stéphane, Mancini Julien, Jego Sophie, San Marco Marielle, Bardin Nathalie
Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France.
Clin Nephrol. 2012 Mar;77(3):211-8. doi: 10.5414/cn107274.
Proliferative glomerulonephritis includes various glomerular lesions in patients with systemic lupus erythematosus (SLE) that might have distinct pathogenic mechanisms. The aim of the study was to determine whether anti-C1q antibodies, which are associated with lupus nephritis, were specifically associated with given glomerular histopathological lesions.
The presence and titer of anti-C1q antibodies were determined in a retrospective study including 63 SLE patients with biopsy-proven lupus nephritis.
We confirmed the correlation between the presence of anti-C1q antibodies with both clinical and immunological markers of disease activity. We showed that the presence of anti- C1q antibodies was significantly associated with glomerular tuft necrosis and crescents, major criteria of active lesions. Additionally, no necrosis was found in patients without anti- C1q antibodies, giving anti-C1q antibodies a 100% negative predictive value for glomerular tuft necrosis. Conversely, there was no difference in the percentage of glomeruli showing endocapillary proliferation or wire loops according to the anti-C1q status.
Our data highlight for the first time an association of anti-C1q antibodies with necrotizing forms of lupus nephritis suggesting new insights into the pathogenesis and the treatment of this entity.
增殖性肾小球肾炎包括系统性红斑狼疮（SLE）患者的各种肾小球病变，其发病机制可能不同。本研究的目的是确定与狼疮性肾炎相关的抗C1q抗体是否与特定的肾小球组织病理学病变存在特异性关联。
在一项回顾性研究中，对63例经活检证实为狼疮性肾炎的SLE患者测定抗C1q抗体的存在情况和滴度。
我们证实了抗C1q抗体的存在与疾病活动的临床和免疫标志物之间的相关性。我们发现抗C1q抗体的存在与肾小球毛细血管袢坏死和新月体显著相关，这是活动性病变的主要标准。此外，在无抗C1q抗体的患者中未发现坏死，抗C1q抗体对肾小球毛细血管袢坏死的阴性预测值为100%。相反，根据抗C1q状态，显示毛细血管内增生或铁丝圈样改变的肾小球百分比无差异。
我们的数据首次强调了抗C1q抗体与坏死性狼疮性肾炎的关联，为该疾病的发病机制和治疗提供了新的见解。
