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Circulating serum anti-C1q antibody: correlation with clinical and histopathological activity in patients with proliferative lupus nephritis

Abstract

Introduction

In systemic lupus erythematosus (SLE) the prevalence of anti-C1q antibodies (Abs) varies from 30 to 50% and is associated with high clinical activity and, particularly, with renal involvement. Moreover, in the absence of anti-C1q auto-Abs, no lupus nephritis occurs, whereas at least 50% of patients with anti-C1q auto-Abs have or develop lupus nephritis. For lupus nephritis, anti-C1q Abs are as specific as high-avidity dsDNA Ab and capable of closing a diagnostic gap in some cases.

Patients and methods

The present study was conducted on 40 patients with SLE. Patients were classified into group I (20 patients with active proliferative lupus nephritis (LN)), group II (10 patients with inactive LN), and group III (10 patients without nephritis). Laboratory investigations were carried out, including complete blood picture, renal functions (blood urea, serum creatinine, and creatinine clearance), complete urine analysis and urine analysis for dysmorphic red blood cells (RBCs), measurement of 24 h urinary proteins, erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and anti-dsDNA, and measurement of serum anti-C1q. Renal biopsy was taken from all patients of group I.

Results

Anti-C1q Abs were significantly higher in group I than in other groups. There were statistically significant positive correlations between anti-C1q Ab level, anti-dsDNA, and percentage of dysmorphic RBCs in urine in group I. There was also a statistically significant positive correlation between anti-C1q Ab level and cellular crescents, leukocyte infiltration, and endocapillary cellularity in the activity index.

Conclusion

Anti-C1q Ab can be used as an indicator of renal activity in patients with lupus nephritis.

References

  1. D’Agati V. Renal disease in systemic lupus erythematosus, mixed connective tissue disease, Sjogren’s syndrome, and rheumatoid arthritis. In: Jennette JC, Olson JL, Schwartz MM, Silva FG, editors. Heptinstall’s pathology of the kidney. Philadelphia, PA: Lippincott-Raven; 1998. 541–624.

    Google Scholar 

  2. Walport MJ. Complement and systemic lupus erythematosus. Arthritis Res 2002; 4: 279–293.

    Article  Google Scholar 

  3. Herrmann M, Voll RE, Lolowos W, et al. Etiopathogenesis of systemic lupus erythematosus. Immunologist 2000; 8: 345–350.

    Google Scholar 

  4. Walport MJ. Complement. First of two parts. N Engl J Med 2001; 344: 1058–1144.

    Article  CAS  Google Scholar 

  5. Walport MJ, Davies KA, Botto M. C1q and systemic lupus erythematosus. Immunobiology 1998; 199: 265–285.

    Article  CAS  Google Scholar 

  6. Trouw LA, Daha MR. Role of anti-C1q autoantibodies in the pathogenesis of lupus nephritis. Expert Opin Biol Ther 2005; 5: 243–251.

    Article  CAS  Google Scholar 

  7. Fremeaux-Bacchi V, Noel LH, Schifferli JA. No lupus nephritis in the absence of anti-C1q autoantibodies? Nephrol Dial Transplant 2002; 17: 2041–2043.

    Article  CAS  Google Scholar 

  8. Trendelenburg M, Lopez-Trascasa M, Potlukova E, Moll S, Regenass S, Frémeaux-Bacchi E, et al. High prevalence of anti C1q antibodies in biopsy-proven active lupus nephritis. Nephrol Dial Transplant 2006; 21: 3115–3121.

    Article  CAS  Google Scholar 

  9. Jaekell HP, Trabandt A, Grobe N, Werle E. Anti-dsDNA antibody subtypes and anti-C1q antibodies: toward a more reliable diagnosis and monitoring of systemic lupus erythematosus and lupus nephritis. Lupus 2006; 15: 335–345.

    Article  CAS  Google Scholar 

  10. Vallerskog T, Gunnarsson I, Widhe M, Risselada A, Klareskog L, van Vollenhoven R, et al. Treatment with rituximab affects both the cellular and the humoral arm of the immune system in patients with SLE. Clin Immunol 2007; 122: 62–74.

    Article  CAS  Google Scholar 

  11. Tan Y, Song D, Wu L-H, Yu F, Zhao M-H. Serum levels and renal deposition of C1q complement component and its antibodies reflect disease activity of lupus nephritis. BMC Nephrol 2013;14: 63–72.

    Article  CAS  Google Scholar 

  12. Nezhad ST, Spaskhah R. Correlation of clinical and pathological finding in patients with LN. A five year experience in Iran. Saudi J Kidney Dis Transpl 2008; 14: 32–40.

    Google Scholar 

  13. Massot C. Lupus diseases. Rev Prat 1998; 48: 640–649.

    Google Scholar 

  14. Balow JE. Clinical presentation and monitoring of LN. Lupus 2005; 14: 25–30.

    Article  CAS  Google Scholar 

  15. Moroni G, Quaglini S, Maccario M, Banfi G, Pnticelli C. Nephritic flares are predictors of bad long term renal outcome in LN. Kidney Int 1996; 50: 2047–2053.

    Article  CAS  Google Scholar 

  16. Austin HA, Boumpas DI, Vaughen EM. Predicting outcome in sever LN: contribution of clinical histological data. Kidney Int 1994; 45: 244–250.

    Article  Google Scholar 

  17. Alba P, Bento L, Cuadrado M, Karim Y, Tungekar M, Abbs I, et al. Anti-dsDNA, anti-Sm antibodies, and the lupus anticoagulant: significant factors associated with lupus nephritis. Ann Rheum Dis 2003; 62: 556–560.

    Article  CAS  Google Scholar 

  18. Al Attia HM. Lupus nephritis among Arabs. Differences with other races; emphasis on clinicopathological and serological perspectives. Saudi J Kidney Dis Transpl 2000; 11: 370–380.

    CAS  PubMed  Google Scholar 

  19. Marto ON, Bertolaccini ML, Calabuig E, Hughes GRV, Khamashta MA. Anti-C1q antibodies in nephritis: correlation between titers and renal disease activity and positive predictive value in SLE. Ann Rheum Dis 2005; 64: 444–448.

    Article  CAS  Google Scholar 

  20. Armstrong DJ, Crockard AD, White-head EM, Bell AL. Anti-C1q antibodies in renal and non-renal SLE. Ann Rheum Dis 2005; 64: 1108.

    Article  CAS  Google Scholar 

  21. Horvath L, Czirjak L, Fekete B, Jakab L, Pozsonyi T, Kalabay L, et al. High levels of Abs against C1q are associated with disease activity and nephritis but not with other organ manifestation in SLE patients. Clin Exp Rheumatol 2001; 19: 667–672.

    CAS  PubMed  Google Scholar 

  22. Siegert CE, Kazatachkine MD, Sioholm A. Auto antibodies against C1q. View on clinical relevance and pathogenic role. Clin Exp Immunol 1999; 116: 4–8.

    CAS  PubMed  Google Scholar 

  23. Cai XY, Yang XY, Chen XH, Liang LQ, Guan MM, Qin SG, et al. Significance of serum anti C1q Ab in evaluation of LN activity and its curative effects of pharmacotherapy on LN. Zhongua Yi Xue Za Zhi 2004; 84: 1436–1439.

    Google Scholar 

  24. Horak P, Hermanova Z, Zadrazil J, Ciferska M, Ordeltova M, Kusal L, et al. C1q complement component and antibodies reflect SLE activity and kidney involvement. Clin Rheumatol 2006; 25: 532–536.

    Article  CAS  Google Scholar 

  25. Chen PC, Wang CR, Liu MF, Chen FF, Liang CC. Correlation between the renal C1q deposition and serum anti C1q Ab: a potential role of anti C1q Ab in lupus nephritis. Asian Pac J Allergy Immunol 2002; 20: 223–227.

    CAS  PubMed  Google Scholar 

  26. Mannik M, Wener M. Deposition of antibodies to the collagen like region of C1q in renal glomeruli of patients with proliferative lupus nephritis. Arthritis Rheum 1997; 40: 1504–1511.

    Article  CAS  Google Scholar 

  27. Heinln LD, McClain MT, Merrill J, Akbarali YW, Edegrton CC, Harley JB, James JA. Clinical criteria for SLE precede diagnosis and associated autoantibodies are present before clinical symptoms. Arthritis Rheum 2007; 56: 2344–2351.

    Article  Google Scholar 

  28. Fang QY, Yu F, Tan Y, Xu L, Wuliu G, Shao F, et al. Anti C1q Ab and IgG subclass distribution in sera from Chinese patients with LN. Nephrol Dial Transplant 2009; 24: 172–178.

    Article  CAS  Google Scholar 

  29. Moura CG, Lima I, Barbosa L, Danieligame RW, Santiaso MB. Anti C1q Abs: association with nephritis and disease activity in SLE. J Clin Lab anal 2009; 23: 19–23.

    Article  Google Scholar 

  30. Coremans IE, Spronk PE, Bootsma H, Daha MR, Vandervoort EA, Kater L, et al. Changes in antibodies to C1q predict renal relapses in SLE. Am J Kidney Dis 1995; 26: 595–601.

    Article  CAS  Google Scholar 

  31. Mosca M, Chimenti D, Pratesi F. Prevalence and clinicoserological correlation of anti alpha enolase, anti C1q Abs and anti ds DNA Abs in patients with SLE. J Rheumatol 2006; 33: 695–697.

    CAS  PubMed  Google Scholar 

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Correspondence to Iman E. El-Gohary PhD.

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Abeed, A.A., Katat, A., El-Gohary, I.E. et al. Circulating serum anti-C1q antibody: correlation with clinical and histopathological activity in patients with proliferative lupus nephritis. Egypt J Intern Med 28, 16–20 (2016). https://doi.org/10.4103/1110-7782.182950

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