Cécile Picard1,2, Jean-Christophe Lega3,4,5, Bruno Ranchin3,6, Pierre Cochat3,6, Natalia Cabrera3,6, Nicole Fabien3,7, Alexandre Belot3,6. 1. Department of Pathology, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France. cecile.picard@chu-lyon.fr. 2. Université Claude Bernard Lyon 1, Lyon, France. cecile.picard@chu-lyon.fr. 3. Université Claude Bernard Lyon 1, Lyon, France. 4. UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, CNRS, Claude Bernard University Lyon 1, University of Lyon, Lyon, France. 5. Department of Internal and Vascular Medicine, Centre Hospitalier Lyon-Sud, Pierre-Benite, CHU de Lyon, Lyon, France. 6. Department of Pediatric Nephrology, Rheumatology and Dermatology, Hospices civils de Lyon, Lyon, France. 7. Department of Immunology, Centre Hospitalier Lyon-Sud, Pierre-Benite, CHU de Lyon, Lyon, France.
Abstract
BACKGROUND: Childhood-onset systemic lupus erythematosus (cSLE) is rare, and considered more severe than its adult-onset counterpart. Lupus nephritis (LN) occurs more frequently in children, accounting for higher long-term morbidity and mortality compared with adults. Thus, reliable biological markers are needed to predict disease course. This study aimed to investigate the capacity of anti-C1q autoantibodies (Abs) to predict renal flare and global disease activity in cSLE patients, and association with disease activity and kidney involvement. METHODS: Twenty-eight patients with cSLE including 19 patients (68%) with a history of LN were included retrospectively. Anti-C1q Abs were analysed by ELISA at renal flare-up or in the quiescent phase of disease and compared with Farr dsDNA assay. RESULTS: Thirty-one flares occurred during follow-up: anti-C1q Abs were positive in 26 (84%), strongly associated with active disease status (p < 0.0001), and correlated with global disease activity score (p < 0.0001) and anti-dsDNA Abs presence (p < 0.0001). The specificity of anti-C1q Abs was higher than anti-dsDNA (73% vs 19%) in discriminating LN patients, whereas the receiver operating characteristic curves were not statistically different (0.83 ± 0.06 vs 0.78 ± 0.08 respectively), similar to C3 dosage. The presence of anti-C1q Abs at diagnosis was not predictive for global or renal flare. Introduction of a modified SLEDAI score excluding dsDNA Abs, demonstrated a stronger correlation of anti-C1q Abs titres with SLEDAI score in comparison with the Farr test. CONCLUSION: Anti-C1q Abs seem very specific to flares, including LN in children, and their role in daily practice compared with the Farr dsDNA assay needs to be defined.
BACKGROUND: Childhood-onset systemic lupus erythematosus (cSLE) is rare, and considered more severe than its adult-onset counterpart. Lupus nephritis (LN) occurs more frequently in children, accounting for higher long-term morbidity and mortality compared with adults. Thus, reliable biological markers are needed to predict disease course. This study aimed to investigate the capacity of anti-C1q autoantibodies (Abs) to predict renal flare and global disease activity in cSLE patients, and association with disease activity and kidney involvement. METHODS: Twenty-eight patients with cSLE including 19 patients (68%) with a history of LN were included retrospectively. Anti-C1q Abs were analysed by ELISA at renal flare-up or in the quiescent phase of disease and compared with Farr dsDNA assay. RESULTS: Thirty-one flares occurred during follow-up: anti-C1q Abs were positive in 26 (84%), strongly associated with active disease status (p < 0.0001), and correlated with global disease activity score (p < 0.0001) and anti-dsDNA Abs presence (p < 0.0001). The specificity of anti-C1q Abs was higher than anti-dsDNA (73% vs 19%) in discriminating LN patients, whereas the receiver operating characteristic curves were not statistically different (0.83 ± 0.06 vs 0.78 ± 0.08 respectively), similar to C3 dosage. The presence of anti-C1q Abs at diagnosis was not predictive for global or renal flare. Introduction of a modified SLEDAI score excluding dsDNA Abs, demonstrated a stronger correlation of anti-C1q Abs titres with SLEDAI score in comparison with the Farr test. CONCLUSION: Anti-C1q Abs seem very specific to flares, including LN in children, and their role in daily practice compared with the Farr dsDNA assay needs to be defined.
Authors: Leendert A Trouw; Tom W L Groeneveld; Marc A Seelen; Jacques M G J Duijs; Ingeborg M Bajema; Frans A Prins; Uday Kishore; David J Salant; J Sjef Verbeek; Cees van Kooten; Mohamed R Daha Journal: J Clin Invest Date: 2004-09 Impact factor: 14.808
Authors: A A Jesus; C A Silva; M Carneiro-Sampaio; M Sheinberg; C L Mangueira; S K Marie; B L Liphaus Journal: Ann N Y Acad Sci Date: 2009-09 Impact factor: 5.691
Authors: Aimee O Hersh; Emily von Scheven; Jinoos Yazdany; Pantelis Panopalis; Laura Trupin; Laura Julian; Patricia Katz; Lindsey A Criswell; Edward Yelin Journal: Arthritis Rheum Date: 2009-01-15