Anti-chromatin and anti-C1q antibodies in systemic lupus erythematosus compared to other systemic autoimmune diseases
Anti-chromatin and anti-C1q antibodies in systemic lupus erythematosus compared to other systemic autoimmune diseases
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DOI：
10.1080/03009740701218717
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发表时间：
2007-01-01
影响因子：
2.1
通讯作者：
Andrassy, K.
中科院分区：
文献类型：
--
作者：
Braun, A.;Sis, J.;Andrassy, K.
目的：评价抗染色质和抗C1q抗体在系统性红斑狼疮(SLE)和狼疮性肾炎中的患病率、敏感性和特异性，并与小血管炎和其他结缔组织病进行比较。为狼疮性肾炎患者抗染色质抗体的长期随访提供资料。方法：我们测定了抗核抗体(ANA)、抗双链DNA(抗dsDNA)、抗染色质抗体、抗C1q抗体以及补体C3和C4与SLE患者疾病活动性的关系。对33例狼疮性肾炎、37例镜下多血管炎、66例韦格纳肉芽肿、17例原发性干燥综合征、6例局限性硬皮病和11例进行性系统性硬皮病患者进行长期随访。结果：抗染色质抗体较抗C1q抗体具有更高的特异性和敏感性[抗染色质抗体敏感性为64.1%，优势比为99.2%，比值比(OR)为219.6；抗C1q：敏感性50%，特异性72.6%，OR 2.65]。75%的干燥综合征患者和35.1%的显微镜下多血管炎患者存在抗C1q抗体。抗dsDNA抗体阴性而ANA阳性的SLE患者，抗染色质抗体可作为SLE的鉴别诊断指标。持续的抗染色质抗体表明SLE疾病活动，即使抗dsDNA抗体已转为阴性。在长期随访中，那些抗dsDNA抗体阴性但持续存在ANA和抗染色质抗体的SLE患者，如果逐渐减少免疫抑制，就会复发。抗染色质抗体与SLE疾病活动性指数(SLEDAI)相关。结论：系统性自身免疫性疾病患者检测抗染色质抗体，但不检测抗C1q抗体，可提高SLE诊断的敏感性和特异性，并有助于抗dsDNA阴性患者的治疗决策。
Objective: To evaluate the prevalence, sensitivity, and specificity of anti-chromatin and anti-C1q antibodies in systemic lupus erythematosus (SLE) and lupus nephritis compared to small vessel vasculitis and other connective tissue diseases. To provide long-term follow-up data for anti-chromatin antibodies in lupus nephritis.Methods: We determined the significance of anti-nuclear antibodies (ANA), anti-double-stranded DNA (anti-dsDNA), anti-chromatin, and anti-C1q antibodies, as well as complement factors C3 and C4, in relation to disease activity in SLE patients with (n=47; long- term follow- up data for 33 patients) and without (n=31) biopsy- confirmed lupus nephritis, microscopic polyangiitis (n=37), Wegener's granulomatosis (n=66), primary Sjogren's syndrome (n=17), limited scleroderma (CREST syndrome) (n=6), and progressive systemic scleroderma ( PSS) ( n=11).Results: Anti-chromatin antibodies were more specific and sensitive than anti-C1q antibodies in distinguishing SLE patients from those with other systemic autoimmune diseases [anti-chromatin: sensitivity 64.1%, specificity 99.2%, odds ratio (OR) 219.6; anti-C1q: sensitivity 50%, specificity 72.6%, OR 2.65]. Anti-C1q antibodies were present in 75% of patients with Sjogren's syndrome and 35.1% of patients with microscopic polyangiitis. Antichromatin antibodies could identify SLE in patients with positive ANA but negative anti-dsDNA antibodies. Persisting anti-chromatin antibodies indicated SLE disease activity, even if anti-dsDNA antibodies had become negative. In long-term follow-up, those SLE patients with negative anti- dsDNA antibodies but persisting ANA and anti- chromatin antibodies relapsed if immunosuppression had been tapered. Anti-chromatin antibodies correlated with the SLE disease activity index (SLEDAI) as a marker of disease activity.Conclusions: The measurement of anti-chromatin, but not anti-C1q, antibodies in patients with systemic autoimmune diseases increases diagnostic sensitivity and specificity for SLE and assists in treatment decisions in anti- dsDNA-negative patients.