Antibodies to ribosomal P proteins in lupus nephritis: A surrogate marker for a better renal survival?

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• 作者：Patrí ; cia Andrade de Macedo^a ; Eduardo Ferreira Borba^a ; Vilma dos Santos Trindade Viana^a ; Elaine Pires Leon^a ; Leonardo de Abreu Testagrossa^b ; Rui Toledo Barros^c ; Ana Patrí ; cia Nascimento^a ; Eloí ; sa Bonfá ; ^a ; ; ^{ebonfa@lim17.fm.usp.br}
• 关键词：Systemic lupus erythematosus ; Autoantibodies ; Anti-ribosomal P protein antibodies ; Glomerulonephritis ; Survival
• 刊名：Autoimmunity Reviews
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：10
• 期：3
• 页码：126-130
• 全文大小：196 K

文摘

Objective

To define if antibodies to ribosomal P proteins disclose a better lupus nephritis long-term survival.

Methods

Sixty consecutive SLE patients with biopsy-proven nephritis (2004 ISN/RPS) were evaluated for renal survival parameters. Inclusion criteria were at least one serum sample at: renal flares, biopsy, and last follow-up until 2008. Anti-P was detected by ELISA/immunoblot and anti-dsDNA by indirect immunofluorescence/ELISA.

Results

Eleven patients (18 % ) with anti-P+ (without anti-dsDNA) during renal flare were compared to 49 (82 % ) persistently negative for anti-P throughout the study. At the final follow-up post-biopsy (6.3 ± 2.5 vs. 6.8 ± 2.4 years, p = 0.36), the comparison of anti-P+/anti-dsDNA− with anti-P− group revealed a trend to lower mean creatinine levels (0.9 ± 0.3 vs. 2.3 ± 2.1 mg/dl, p = 0.07), lower frequency of dialysis (0 % vs. 35 % , p = 0.025), and higher frequency of normal renal function (91 % vs. 53 % , p = 0.037). The overall renal survival was significantly higher in anti-P+/anti-dsDNA− compared to anti-P− (11.0 ± 4.5 vs. 9.2 ± 4.5 years, p = 0.033), anti-dsDNA+/anti-P− (vs. 8.7 ± 4.7 years, p = 0.017), and anti-P−/anti-dsDNA− (vs. 9.8 ± 4.3 years, p = 0.09) groups.

Conclusion

Our data supports the notion that anti-P antibody in the absence of anti-dsDNA during nephritis flares is a valuable marker to predict a better long-term renal outcome in lupus patients.