Division of Nephrology, Fondazione Ospedale Maggiore, Mangiagalli, Regina Elena, 20122 Milano, Italy.
Department of Informatics, Università degli Studi di Pavia, 27100 Pavia, Italy.
J Immunol Res. 2015;2015:106904. doi: 10.1155/2015/106904. Epub 2015 Feb 26.
Few studies have correlated serum biomarkers with renal histology, the gold standard for renal activity, in lupus nephritis (LN). We tested a panel of autoantibodies and complement at the time of kidney biopsy and after treatment. Anti-dsDNA, anti-nucleosome, anti-ribosome P, and anti-C1q antibodies and C3/C4 were measured in 107 patients with LN at the time of renal biopsy and after 6-12 months and were correlated with clinical/histological parameters. At multivariate analysis, high titers of anti-C1q antibodies or of anti-dsDNA antibodies (P = 0.005, OR = 8.67, CI: 2.03-37.3) were the independent predictors that discriminate proliferative from nonproliferative LN. All the immunological parameters, except anti-ribosome, showed a significant correlation with activity index but not with chronicity index. Only anti-C1q showed a significant correlation with the amount of proteinuria (R = 0.2, P = 0.03). None of the immunological parameters were predictive of remission at 6 and 12 months. We found that anti-C1q alone or in combination with anti-dsDNA emerged as the most reliable test in differentiating proliferative and nonproliferative LN. Anti-C1q was the only test correlated with the clinical presentation of LN. After treatment, the titre of the autoantibodies was significantly reduced, but none was predictive of remission.
很少有研究将血清生物标志物与狼疮肾炎 (LN) 的肾组织学（金标准）相关联。我们在肾活检时和治疗后检测了一组自身抗体和补体。在 107 例 LN 患者的肾活检时和 6-12 个月后，检测了抗 dsDNA、抗核小体、抗核糖体 P、抗 C1q 抗体和 C3/C4，并与临床/组织学参数相关联。在多变量分析中，高滴度的抗 C1q 抗体或抗 dsDNA 抗体（P=0.005，OR=8.67，CI：2.03-37.3）是区分增殖性与非增殖性 LN 的独立预测因子。除了抗核糖体抗体外，所有免疫参数均与活动指数显著相关，但与慢性指数无关。只有抗 C1q 与蛋白尿量呈显著相关性（R=0.2，P=0.03）。免疫参数均不能预测 6 个月和 12 个月时的缓解。我们发现，抗 C1q 单独或与抗 dsDNA 联合使用是区分增殖性和非增殖性 LN 的最可靠检测方法。抗 C1q 是唯一与 LN 临床表现相关的检测方法。治疗后，自身抗体的滴度显著降低，但均不能预测缓解。
