Chiu Y Y, Nisihara R M, Würzner R, Kirschfink M, de Messias-Reason I J
Department of Clinical Pathology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil.
J Investig Allergol Clin Immunol. 1998 Jul-Aug;8(4):239-44.
This study investigated whether increased plasma levels of terminal complement complex (SC5b-9) or split products correlate with disease activity and clinical manifestations in Brazilian systemic lupus erythematosus (SLE) patients. Comparisons with conventional measurements of complement and other inflammatory markers were also performed. Plasma levels of SC5b-9, C3a desArg, C1rs-C1Inhibitor, C3b(Bb)P, C3, C4, erythrocyte sedimentation rate (ESR) and mucoproteins (MP) were measured in 41 patients with SLE of different disease activity: 10 patients with none, 15 patients with mild, and 16 patients with moderate or severe activity. All parameters, with the exception of C3 and C3b(Bb)P, showed a statistically significant correlation with disease activity. Plasma levels of SC5b-9, C3a desArg, C4, CH50, ESR and MP revealed significant differences between the groups of patients without activity and those with moderate or severe disease. Although none of the variables were able to discriminate between patients without and those with mild activity, SC5b-9, C3a desArg, C4, ESR and mucoproteins showed significant differences between the patients with mild and those with moderate or severe disease. Among all the variables, SC5b-9 levels showed the most significant results and correlated well with the severity of the disease (p < 0.0005). Our data suggest that elevated levels of complement activation products, particularly of SC5b-9 are more sensitive markers in assessing disease activity than conventional laboratory diagnosis. Modern complement diagnosis is therefore recommended for monitoring disease progress in SLE patients.
本研究调查了巴西系统性红斑狼疮（SLE）患者血浆中终末补体复合物（SC5b - 9）水平升高或裂解产物是否与疾病活动度及临床表现相关。同时还与补体及其他炎症标志物的传统检测指标进行了比较。对41例不同疾病活动度的SLE患者检测了血浆中SC5b - 9、C3a desArg、C1rs - C1抑制剂、C3b（Bb）P、C3、C4、红细胞沉降率（ESR）和粘蛋白（MP）的水平：10例无疾病活动的患者，15例轻度疾病活动的患者，以及16例中度或重度疾病活动的患者。除C3和C3b（Bb）P外，所有参数均与疾病活动度呈统计学显著相关。SC5b - 9、C3a desArg、C4、总补体活性（CH50）、ESR和MP的血浆水平在无疾病活动的患者组与中度或重度疾病患者组之间存在显著差异。虽然没有一个变量能够区分无疾病活动的患者和轻度疾病活动的患者，但SC5b - 9、C3a desArg、C4、ESR和粘蛋白在轻度疾病患者与中度或重度疾病患者之间显示出显著差异。在所有变量中，SC5b - 9水平显示出最显著的结果，且与疾病严重程度相关性良好（p < 0.0005）。我们的数据表明，补体激活产物水平升高，尤其是SC5b - 9，在评估疾病活动度方面比传统实验室诊断更敏感。因此，建议采用现代补体诊断方法来监测SLE患者的疾病进展。
