Department of Nephrology, First Hospital Affiliated to Harbin Medical University, 150001, Harbin, China.
J Clin Immunol. 2013 Feb;33(2):378-87. doi: 10.1007/s10875-012-9825-6. Epub 2012 Oct 26.
The purpose of this study is to examine autoantibody profile of systemic lupus erythematosus (SLE) patients with lupus nephritis (LN) and to establish the correlation between the antibody reactivity and disease activity of LN.
Autoantibodies and serological parameters were measured and analyzed in 589 SLE patients. The associations of the co-positivity of anti-dsDNA, -nucleosome and -histone antibodies (3-pos) with clinical, serological and outcome parameters were analyzed.
At the study entry, the prevalence for anti-dsDNA (61.52 % vs. 34.11 %, P < 0.0001), anti-nucleosome (56.09 % vs. 37.21 %, P = 0.0002) and anti-histone (49.35 % vs. 33.33 %, P = 0.0013) antibodies in patients with LN were significantly higher than that in patients without LN. Patients with 3-pos had a higher proportion of proliferative renal lesions (class III + IV). The incidence of a poor renal outcome (7.14 % vs. 2.52 %, P = 0.0174) in LN patients with 3-pos was significantly higher than those without 3-pos. Moreover, the rate of remission (73.63 % vs. 82.37 %, P = 0.0245) was significantly reduced and recurrence increased (58.90 % vs. 23.44 %, P < 0.0001) in 3-pos patients as compared to that in non 3-pos within the LN group.
Our data indicate a strong association between the 3-pos and renal disease activities, especially proliferative glomerulonephritis. The ability of 3-pos to predict renal flares may lead to major additional benefits in the follow-up of these patients.
本研究旨在探讨狼疮肾炎（LN）患者的自身抗体谱，并建立抗体反应与 LN 疾病活动度的相关性。
对 589 例系统性红斑狼疮（SLE）患者进行了自身抗体和血清学参数的检测和分析。分析了抗 dsDNA、核小体和组蛋白抗体（3 项阳性）与临床、血清学和预后参数的相关性。
在研究开始时，LN 患者抗 dsDNA（61.52% vs. 34.11%，P<0.0001）、抗核小体（56.09% vs. 37.21%，P=0.0002）和抗组蛋白（49.35% vs. 33.33%，P=0.0013）抗体的阳性率明显高于无 LN 患者。3 项阳性患者中增殖性肾病变（III+IV 级）的比例更高。3 项阳性的 LN 患者不良肾脏结局（7.14% vs. 2.52%，P=0.0174）的发生率明显高于无 3 项阳性患者。此外，与非 3 项阳性患者相比，3 项阳性患者的缓解率（73.63% vs. 82.37%，P=0.0245）明显降低，复发率（58.90% vs. 23.44%，P<0.0001）升高。
我们的数据表明，3 项阳性与肾脏疾病活动度之间存在很强的相关性，特别是增殖性肾小球肾炎。3 项阳性预测肾脏发作的能力可能会为这些患者的随访带来重大的额外益处。
