Association of anti C1q and ds-DNA levels with the pathogenesis of Lupus Nephritis among SLE patients

Zara Sohail, Arshad Jamal, Ahmed Bilal Waqar, Khurshid Iqbal, Sajjad Ullah

Abstract


Background: Lupus nephritis (LN) is the most common and serious complication associated with SLE and it results in significant morbidity and mortality. It is known by several studies that patients of LN have higher levels of anti-dsDNA and anti-C1q compared with SLE patients without renal involvement. The current study was designed to determine and compare the level of anti-dsDNA and anti-C1q in patients of SLE with and without lupus nephritis in the Pakistani population. This current study was also aimed at providing proof that anti-C1q levels are more prominent in LN/non-LN SLE as compared to anti-dsDNA. This project may help in the determination of results in Pakistan and contribute to the further confirmation of the sensitivity of anti-C1q.

Method: The patient samples were collected from Sheikh Zayed hospital, Lahore. These patients were clinically diagnosed by the Rheumatologists as SLE and LN positive on the basis of ACR and SLEDAI scoring criteria. This study was performed and samples were analyzed in the Department of Medical and Laboratory Sciences, Imperial College of Business Study, Lahore on the patient’s serum by ELISA technique.

Result: About 38% (12) patients with LN were positive for anti-dsDNA and 31% (9) SLE patients without LN were positive whereas about 38.7% (12) were anti-dsDNA negative in LN cases and 58.6% (17) in SLE without LN. In case of anti-C1q 100% (31) of these LN patients were positive and 93.1% (27) patients SLE without LN showed positive anti C1q results. Only 6.9% (2) patients showed negative results for anti-C1q in LN negative patients

Conclusion: The higher levels of anti-C1q suggest that it may be a better diagnostic marker for LN than that of anti-dsDNA and that it can be helpful in the prognosis of SLE patients.


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References


Levinson W. Immune tolerance and autoimmune diseases: Microbiology and Immunology. (2010); 14: 567-575. The McGrew Hill companies, USA.

Mayer G. Microbiology and immunology online, chapter thirteen, cytokines and immunoregulation. http://pathmicro.med.sc.edu/bowers/imm-reg-ver2.html, accessed on June 2016.

Ortega L, Schultz D, Lenz O, Pardo V, Contreras G. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions. Lupus, (2010); 19(5): 557-74.

Helmick C, Felson D, Lawrence R, Gabriel S, Hirsch R, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part I. Arthritis & Rheumatology, (2008); 58(1): 15-25.

Pons-Estel G, Alarcón G, Scofield L, Reinlib L, Cooper G. Understanding the epidemiology and progression of systemic lupus erythematosus. Arthritis Rheum. (2010); 4: 39-257.

Rabbani M, Siddiqui B, Tahir M, Ahmad B, Shamim A, et al. Systemic lupus erythematosus in Pakistan. Lupus, (2004); 13: 820-5.

Ayensa J, Khamashta M, Ruiz-Irastorza G. A new role for antimalarials in systemic lupus erythematosus treatment. International Journal of Clinical Rheumatology, (2010); 5: 299-312.

Bertsias G and Cervera R.Systemic Lupus Erythematosus: Pathogenesis and Clinical Feature.http://www.eular.org/myUploadData/files/sample%20chapter20_mod%2017.pdf.accessed on Sep 2016.

Mizuno M, Suzuki Y, Ito Y. Complement regulation and kidney diseases: recent knowledge of the double-edged roles of complement activation in nephrology. Clinical and Experimental Nephrology, (2017); 24: 1-2.

Christopher-Stine L, Petri M, Astor B, Fine D. Urine protein-to-creatinine ratio is a reliable measure of proteinuria in lupus nephritis. Journal of rheumatology, (2004); 1: 1557-9.

Katsumata Y, Miyake K, Kawaguchi Y, Okamoto Y, Kawamoto M, et al. Anti‐C1q antibodies are associated with systemic lupus erythematosus global activity but not specifically with nephritis: A controlled study of 126 consecutive patients. Arthritis & Rheumatism, (2011); 63(8): 2436-44.

Kallenberg C. Anti-C1qautoantibodies. Autoimmunity Reviews, (2008); 7: 612–5.

Morgan B and Walport W. Complement deficiency and disease. Immunology, (1991);12: 301.

El-Hewala A, Nageeb G, El-shahawy E, Sharaf D, Omran A, El-Messallamy F, Eassa S. Anti-C1q and anti-dsDNA antibodies in systemic lupus erythematosus: Relationship with disease activity and renal involvement in Sharkia governorate, Egypt. The Egyptian Rheumatologist, (2011); 1: 203-8.

Chen Z, Wang G, Wang G, Li X. Anti-C1qantibody is a valuable biological marker for prediction of renal pathological characteristics in lupus nephritis. Clinical rheumatology, (2012); 31(9): 1323-9.

Kavanaugh A, Tomar R, Reveille J, Solomon D, Homburger H. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. Archives of pathology & laboratory medicine, (2000); 124(1): 71-81.

Yung S, Chan T. Mechanisms of kidney injury in lupus nephritis–the role of anti-dsDNA antibodies. Frontiers in immunology, (2015); 6: 475.

Egner W. The use of laboratory tests in the diagnosis of SLE. Journal of Clinical Pathology, (2000); 53: 424–32.

Chen M, Daha M, Kallenberg C. The complement system in systemic autoimmune disease. Journal of autoimmunity, (2010); 34(3): 276-86.

Coremans I, Spronk P. Changes in antibodies to Clq predict renal relapses in systemic lupus erythematosus. American Journal Kidney Diseases, (1995); 26: 595.

Leung Y, Szeto C, Tam L, Lam C, Li E, et al. Urine protein-to-creatinine ratio in an untimed urine collection is a reliable measure of proteinuria in lupus nephritis. Rheumatology, (2007): 46(4): 649-52.

Rasheed S, Afzal N, Tarif N, Shehzad F and Mahmood T. Increased level of urinary neutrophil gelatinase associated lipocalin protein in patients of lupus nephritis, (2016) 1:1

Ding Y, He J, Guo J, Dai Y, Li C, et al. Gender differences are associated with the clinical features of systemic lupus erythematosus. Chinese medical journal, (2012); 125(14): 2477-81.

Picard C, Lega J, Ranchin B, Cochat P, Cabrera N, et al. Anti-C1qautoantibodies as markers of renal involvement in childhood-onset systemic lupus erythematosus. Pediatric Nephrology, (2017); 32(9): 1537-45.

Omran E, Ismail N, Mosad E, Hussein Y. Anti-C1qantibodies as a marker for disease activity in systemic lupus erythematosus and lupus nephritis. Journal of Current Medical Research and Practice, (2016); 1(3): 47.

Birmingham D, Bitter J, Ndukwe E, Dials S, Gullo T, et al. Relationship of circulating Anti-C3b and Anti-C1qIgG to lupus nephritis and its flare. Clinical Journal of the American Society of Nephrology, (2016); 11(1): 47-53.

Radanova M, Bratoeva K, Vasilev V, Deliyska B, Lazarov V, et al. Association between anti-C1qand anti-dsdna antibodies in patients with lupus nephritis. Medicine, (2015); (1)-5

Li H, Lin S, Yang S, Chen L, Zheng X. Diagnostic value of serum complement C3 and C4 levels in Chinese patients with systemic lupus erythematosus. Clinical rheumatology,(2015); 34(3): 471-7.

Mok C, Tang S, To C, Petri M. Incidence and risk factors of thromboembolism in systemic lupus erythematosus: a comparison of three ethnic groups. Arthritis & Rheumatism, (2005); 1: 2774-82.




DOI: http://dx.doi.org/10.62940/als.v5i2.516

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