Zhou Yan, Chen Peirong, Li Yongji
Department of Rheumatology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.
Int J Rheum Dis. 2019 Dec;22(12):2185-2190. doi: 10.1111/1756-185X.13733. Epub 2019 Nov 21.
The mechanism of glomerular microthrombosis (GMT) in patients with lupus nephritis (LN) is largely unknown. The aim of this study is to investigate the association between antiphospholipid antibodies (aPLs) and factor Bb in LN patients with GMT.
Patients with biopsy-proven LN hospitalized from July 2015 to July 2018 in our hospital were selected for this study. Levels of lupus anticoagulant (LAC), anticardiolipin antibodies (aCLs), anti-β2-glycoprotein I (anti-β2-GPI) antibodies and factor Bb were measured, and other clinical and pathological data were also obtained during the same period before renal biopsy.
A total of 25 LN patients with GMT and 76 LN patients without GMT were included in this study. In LN patients with GMT, the presence of anti-β2GPI and LAC were both significantly higher than in those without GMT (P < .001 and P = .039, respectively). The level of factor Bb was also higher in LN patients with GMT than in those without GMT (P = .021). In the correlation analysis, Bb level was positively correlated with serum creatinine (r = 0.28, P = .014), activity index (r = 0.24, P = .021) GMT (r = 0.65, P < .001) and IgG-anti-β2GPI (r = 0.771, P < .001).
Our work suggests that aPLs, especially IgG-anti-β2GPI, may play a role in the progress of GMT, and this process might involve alternative complement activation.
狼疮性肾炎(LN)患者肾小球微血栓形成(GMT)的机制尚不清楚。本研究旨在探讨抗磷脂抗体(aPLs)与LN合并GMT患者中B因子b的相关性。
选取2015年7月至2018年7月在我院住院的经活检证实为LN的患者进行本研究。检测狼疮抗凝物(LAC)、抗心磷脂抗体(aCLs)、抗β2糖蛋白I(抗β2-GPI)抗体及B因子b水平,并在肾活检前同期获取其他临床和病理资料。
本研究共纳入25例LN合并GMT患者和76例LN未合并GMT患者。LN合并GMT患者中,抗β2GPI和LAC的阳性率均显著高于未合并GMT的患者(分别为P <.001和P =.039)。LN合并GMT患者的B因子b水平也高于未合并GMT的患者(P =.021)。相关性分析显示,Bb水平与血清肌酐(r = 0.28,P =.014)、活动指数(r = 0.24,P =.021)、GMT(r = 0.65,P <.001)及IgG-抗β2GPI(r = 0.771,P <.001)呈正相关。
我们的研究表明,aPLs,尤其是IgG-抗β2GPI,可能在GMT的进展中起作用,且这一过程可能涉及替代补体激活。