Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 7-8, Pages: 431-436
https://doi.org/10.2298/SARH1408431Z
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Anti-dsDNA, anti-nucleosome and anti-C1q antibodies as disease activity markers in patients with systemic lupus erythematosus
Živković Valentina (Institute for Treatment and Rehabilitation “Niška Banja”, Niš)
Stanković Aleksandra (Institute for Treatment and Rehabilitation “Niška Banja”, Niš)
Cvetković Tatjana (Clinic for Nephrology, Clinical Center, Niš)
Mitić Branka (Clinic for Nephrology, Clinical Center, Niš)
Kostić Svetislav (Clinic for Nephrology, Clinical Center, Niš)
Nedović Jovan (Institute for Treatment and Rehabilitation “Niška Banja”, Niš)
Stamenković Bojana (Institute for Treatment and Rehabilitation “Niška Banja”, Niš)
Introduction. In spite of the growing number of reports on the study of
anti-nucleosome and anti-C1q antibodies, there are still controversies on
their significance as disease activity markers in patients with systemic
lupus erythematosus (SLE) and their use in everyday clinical practice.
Objective. Our aim was to assess the presence of anti-dsDNA, anti-nucleosome
and anti-C1q antibodies in SLE patients, as well as to establish their
sensitivity, specificity, positive and negative predictive value, and their
correlation with SLE and lupus nephritis clinical activity. Methods. The
study enrolled 85 patients aged 45.3±9.7 years on the average, with SLE of
average duration 10.37±7.99 years, hospitalized at the Institute „Niška
Banja“ during 2011, and 30 healthy individuals as controls. Disease activity
was assessed using Systemic Lupus Erythematosus Disease Activity Index
(SLEDAI). In all examinees the levels of anti-dsDNA, anti-nucleosome and
anti-C1q antibodies were measured using the ELISA method with Alegria Test
Strips Orgentec (Germany). Results. Patients with active lupus nephritis had
a higher presence of anti-C1q antibodies and higher co-positivity of
anti-dsDNA, anti-nucleosome, and anti-C1q antibodies compared to those with
inactive lupus nephritis (77.77% vs. 21.74%; p<0.01). SLE patients with
SLEDAI ≥11 had a higher presence of antinucleosome (93.75% vs. 64.15%;
p<0.01) and anti-C1q antibodies (46.87% vs. 22.64%; p<0.05), as well as a
higher mean level of anti-nucleosome antibodies (107.79±83.46 U/ml vs.
57.81±63.15 U/ml; p<0.05), compared to those with SLEDAI of 0-10. There was a
positive correlation between the SLEDAI and the level of anti-dsDNA (r=0.290;
p<0.01), anti-nucleosome (r=0.443; p<0.001), and anti-C1q antibodies
(r=0.382; p<0.001). Only anti-C1q antibodies demonstrated correlation with
proteinuria (r=0.445; p<0.001). Conclusion. Anti-nucleosome and anti-C1q
antibodies demonstrated association with SLE and lupus nephritis activity,
suggesting their potential usefulness in making predictions about lupus
nephritis and assessment of disease activity.
Keywords: systemic lupus erythematosus, anti-dsDNA antibodies, anti-nucleosome antibodies, anti-C1qantibodies, lupus nephritis, SLEDAI