IgG subclass distribution of autoantibodies differs between renal and extra-renal relapses in patients with systemic lupus erythematosus
IgG subclass distribution of autoantibodies differs between renal and extra-renal relapses in patients with systemic lupus erythematosus
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DOI：
10.1093/rheumatology/41.1.62
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发表时间：
2002-01-01
期刊：
影响因子：
5.5
通讯作者：
Kallenberg, CGM
中科院分区：
文献类型：
--
作者：
Bijl, M;Dijstelbloem, HM;Kallenberg, CGM
背景自身抗体的IgG亚类在其诱导炎症反应的潜力方面不同，因为它们与补体和Fc γ受体的相互作用不同。对系统性红斑狼疮患者肾外复发（n=23）或肾内复发（n=17）前和复发时抗核组蛋白和抗dsDNA抗体的IgG亚类分布进行了纵向分析。对肾复发患者的肾活检标本进行IgG亚类沉积分析。40例患者中有39例血浆中存在IgG1抗核组蛋白和IgG1抗dsDNA抗体。在复发的那一刻，IgG2和IgG3抗核组蛋白和IgG2抗dsDNA抗体更频繁地存在于肾脏疾病患者相比，那些与肾外疾病。在肾复发前的11例患者中，有10例患者的IgG1抗dsDNA水平升高，但在肾外复发的22例患者中，仅有10例患者的IgG1抗dsDNA水平升高（91 vs 45%，P=0.02）。在肾和肾外复发之前，IgG2抗dsDNA的升高率同样低。IgG2抗核组蛋白抗体的升高发生在11例患者中的8例肾复发和22例患者中的4例肾外复发之前（73 vs 18%，P=0.006）。在肾活检中，可以检测到所有IgG亚类。抗核组蛋白和抗dsDNA抗体的IgG1和IgG2亚类是狼疮肾病患者血浆中发现的主要亚类。肾复发前患者中经常出现IgG 2抗核组蛋白和IgG 1抗dsDNA升高，这表明除了IgG 1亚类自身抗体外，抗核组蛋白的IgG 2亚类抗体在狼疮性肾炎中具有特殊的病理生理作用。
Background. IgG subclasses of autoantibodies differ in their potential to induce an inflammatory response as they interact differentially with complement and Fcgamma receptors.Methods. The IgG subclass distribution of anti-nucleohistone and anti-dsDNA antibodies was analysed longitudinally in patients with systemic lupus erythematosus before and at the moment of an extra-renal (n=23) or a renal relapse (n=17). Kidney biopsy specimens of patients with a renal relapse were analysed for IgG subclass deposition.Results. IgG1 anti-nucleohistone and IgG1 anti-dsDNA antibodies were present in plasma of 39 out of 40 patients. At the moment of a relapse, IgG2 and IgG3 anti-nucleohistone and IgG2 anti-dsDNA antibodies were more frequently present in patients with renal disease compared with those with extra-renal disease. Increases in levels of IgG1 anti-dsDNA were observed in 10 out of 11 patients prior to a renal relapse but only 10 out of 22 patients with an extra-renal relapse (91 vs 45%, P=0.02). Rises in IgG2 anti-dsDNA occurred at an equally low rate prior to both renal and extra-renal relapses. A rise in IgG2 anti-nucleohistone antibodies preceded a renal relapse in eight of 11 patients and an extra-renal relapse in only four out of 22 patients (73 vs 18%, P=0.006). In kidney biopsies all IgG subclasses could be detected. IgG1 and IgG2 subclass antibodies to nucleohistone and to dsDNA are the predominant subclasses found in plasma of lupus patients with renal disease.Conclusions. The frequent occurrence of a rise in IgG2 anti-nucleohistone and IgG1 anti-dsDNA in patients prior to a renal relapse suggests that, besides IgG1 subclass autoantibodies, IgG2 subclass antibodies to nucleohistone have a particular pathophysiological role in lupus nephritis.