Association of Blood Concentrations of Complement Split Product iC3b and Serum C3 With Systemic Lupus Erythematosus Disease Activity.
Association of Blood Concentrations of Complement Split Product iC3b and Serum C3 With Systemic Lupus Erythematosus Disease Activity.
复制标题
补体分裂产物IC3B和血清C3的血液浓度与全身性红斑狼疮活性的关联。
DOI：
10.1002/art.40747
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Atkinson JP
中科院分区：
文献类型：
--
作者：
Kim AHJ;Strand V;Sen DP;Fu Q;Mathis NL;Schmidt MJ;Bruchas RR;Staten NR;Olson PK;Stiening CM;Atkinson JP
旨在检查补体分裂产物 iC3b 和血清成分 C3 的血液水平与系统性红斑狼疮 (SLE) 患者疾病活动性有临床意义的变化之间的相关性。总共 159 名连续的根据美国风湿病学会或系统性狼疮国际合作诊所分类标准诊断的 SLE 患者参加了一项前瞻性观察性研究 CASTLE（系统性红斑狼疮补体激活特征）。进行过 1-7 次研究访视的患者被纳入该纵向分析中。此外，还招募了48名健康志愿者来建立血液iC3b与血清C3浓度之比的正常参考值。通过比浊法测量血清 C3 和 C4 水平，并通过侧流测定法测量血液 iC3b 水平。使用 SLE 疾病活动指数 2000 的 Responder Index 50 仪器监测 SLE 疾病活动性。 iC3b:C3 比率的相对变化、抗双链 DNA (抗 dsDNA) 抗体水平以及超生理剂量泼尼松 (>7.5 mg/天) 的使用均与 SLE 疾病活动性独立相关，如多水平多重 Logistic 回归分析所确定。在接受超生理剂量泼尼松的 SLE 患者中，只有 iC3b:C3 比率与具有临床意义的疾病活动改善显着相关。在区分活动性 SLE 与非活动性 SLE 以及主要耀斑与无疾病活动性方面，iC3b:C3 比率优于 C3 和 C4 水平。 iC3:C3 比率、抗 dsDNA 抗体水平、红细胞沉降率和超生理泼尼松剂量的使用均与狼疮性肾炎的存在独立相关，而这些指标均与 SLE 皮疹无关。 iC3b:C3 比率与狼疮性肾炎的关联独立于其他观察到的临床表现。血液 iC3b 与血清 C3 浓度的比率与 SLE 疾病活动程度以及 SLE 患者疾病活动的临床有意义的变化相关。此外，iC3b:C3 比率可以区分活动性和非活动性 SLE，以及主要发作和无活动性疾病。
To examine correlations between blood levels of complement split product iC3b and serum component C3 with clinically meaningful changes in disease activity in patients with systemic lupus erythematosus (SLE). A total of 159 consecutive patients with SLE, diagnosed according to the American College of Rheumatology or Systemic Lupus International Collaborating Clinics classification criteria, were enrolled in CASTLE (Complement Activation Signatures in Systemic Lupus Erythematosus), a prospective observational study. Patients with 1–7 study visits were included in this longitudinal analysis. In addition, 48 healthy volunteers were enrolled to establish a normal reference value for the ratio of blood iC3b to serum C3 concentrations. Serum C3 and C4 levels were measured by nephelometry, and blood iC3b levels were measured by a lateral flow assay. SLE disease activity was monitored with the Responder Index 50 instrument of the SLE Disease Activity Index 2000. Relative changes in the iC3b:C3 ratio, levels of anti–double‐stranded DNA (anti‐dsDNA) antibodies, and use of a supraphysiologic dose of prednisone (>7.5 mg/day) each independently correlated with SLE disease activity, as determined in multilevel multiple logistic regression analyses. Only the iC3b:C3 ratio was significantly associated with clinically meaningful improvements in disease activity among patients with SLE who were receiving a supraphysiologic dose of prednisone. The iC3b:C3 ratio outperformed C3 and C4 levels with regard to discriminating active SLE from inactive SLE, and major flares from no disease activity. The iC3:C3 ratio, anti‐dsDNA antibody levels, erythrocyte sedimentation rate, and use of a supraphysiologic prednisone dose were each independently associated with the presence of lupus nephritis, whereas none of these measures was associated with SLE rash. The association of the iC3b:C3 ratio with lupus nephritis was independent of other observed clinical manifestations. The ratio of blood iC3b to serum C3 concentrations correlates with the extent of SLE disease activity and with clinically meaningful changes in disease activity in patients with SLE. Furthermore, the iC3b:C3 ratio may discriminate between active and inactive SLE, and between major flares and no active disease.
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影响因子：
27.4
作者：
BEDWELL, AE;ELSON, CJ;CZUDEK, R
通讯作者：
CZUDEK, R
影响因子：
--
作者：
HOPKINS, P;BELMONT, HM;ABRAMSON, SB
通讯作者：
ABRAMSON, SB
影响因子：
11.4
作者：
DELCAYRE, AX;SALAS, F;LERNHARDT, W
通讯作者：
LERNHARDT, W
影响因子：
--
作者：
Manzi, S;Rairie, JE;RamseyGoldman, R
通讯作者：
RamseyGoldman, R
影响因子：
--
作者：
BUYON, JP;TAMERIUS, J;ABRAMSON, SB
通讯作者：
ABRAMSON, SB