抗C1q抗体在评价狼疮性肾炎活动性中的作用

目的 探讨抗C1q抗体在评价狼疮性肾炎(LN)疾病总体活动性和肾脏活动性中的作用.方法 选择2008年8月至2011年8月于北京大学深圳医院肾活检病理诊断为LN患者46例.ELISA方法检测血清抗C1q抗体滴度,比较该抗体与LN的活动性评分如SLEDAI评分、m-SLEDAI(modified SLEDAI)评分和肾脏活动性指数(RAS)等相关性.结果 抗Clq抗体滴度与SLEDAI、m-SLEDAI呈正相关.当肾脏活动指数RAS ＞11分时,抗C1q抗体(＞20u/ml)、抗dsDNA抗体(＞100u/ml)、补体C3＜0.8mmol/L)、CRP(＞ 8mg/L)与对应的RAS值进行卡方检验,抗C1q抗体和抗dsDNA抗体差异有统计学意义(P＜0.05),皮尔逊卡方值分别为17.043,8.696,其列联系数分别为0.807、0.633.结论 预测LN疾病整体活动性时,抗C1q抗体优于抗dsDNA抗体、补体C3;它与肾脏活动性指数有较好的对应关系.     

抗核小体抗体与狼疮肾炎活动性关系的研究

目的探讨抗核小体抗体与狼疮肾炎活动性的关系。方法对2007年4月至2009年12月在我院住院的75例经肾活检确诊为狼疮肾炎患者的临床资料进行回顾性研究。结果抗核小体抗体在活动性增殖性狼疮肾炎中的阳性率（59．3％）较非活动性增殖性狼疮肾炎（27．3％）和非增殖性狼疮肾炎（20．0％）高（P〈0．05）。活动性狼疮肾炎组的抗核小体抗体阳性率（53．8％）较非活动性狼疮‘肾炎组阳性率（23．8％）高（P〈0．05）。抗核小体抗体阳性组的病理活动性指数（active index,AI）较阴性组高（P〈0．05）,两组慢性指数（chronic index.CI）和狼疮肾炎的临床活动性评分（renalactivity score,RAS）无显著差异（P〉0．05）。结论抗核小体抗体与狼疮肾炎的病理活动性相关,在活动性增殖性狼疮肾炎中出现较为普遍,是提示活动性增殖性狼疮肾炎的一项重要的指标。     

狼疮性肾炎中抗内皮细胞抗体和抗心磷脂抗体的关系

目的 进一步探讨狼疮性肾炎（ＬＮ）中抗内皮细胞抗体（ＡＥＣＡ）和抗心磷脂抗体（ＡＣＡ）的关系。方法 采用ＥＬＩＳＡ方法对５８例ＬＮ患者血清进行了ＡＥＣＡ和ＡＣＡ检测，并应用免疫印迹方法对ＡＥＣＡ的抗原进行分析。结果 在狼疮性肾炎中ＡＥＣＡ与ＡＣＡ阳性率分别为３６．２％和３９．７％，在２３例ＡＣＡ阳性患者中，１７例ＡＥＣＡ阳性，而３５例ＡＣＡ阴性患者中只有４例ＡＥＣＡ阳性，两者比较具有显著性差异（Ｐ     

狼疮性肾炎的治疗新进展

目前对狼疮性肾炎的治疗已经开展了很多临床试验,然而直到现在没有那种药物可以单独成为治疗LN的新标准方案。对这些前瞻性和回顾性研究进行整合分析,注意到这些研究的局限性,提出更合理的治疗LN研究方案。在临床工作中要根据每例患者的临床表现、疾病的活动水平、病理改变、药物耐受程度、自愿度和前期治疗等进行个体化治疗是非常重要的。     

狼疮性肾炎发病机制研究进展

SLE是一种累及多系统、多脏器的非特异性自身免疫性疾病,多种自身抗原参与SLE发生和发展,而且还会引起肾脏受累的一种疾病.本文主要是针对狼疮肾炎的发病机制进行综述,包括抗dsDNA抗体、细胞毒性T细胞以及脱氧核糖核酸酶(DNase1)等致肾炎.抗dsDNA的抗体一般仅限于系统性红斑狼疮,研究可知GBM中染色质免疫沉积物...     

抗脂蛋白酶抗体与狼疮肾炎的关系

狼疮肾炎（LN）是系统性红斑狼疮（SLE）的一种严重并发症，SLE常伴有脂质代谢异常。本研究旨在探讨抗脂蛋白酶抗体（anti-LPL）与LN的关系。     

狼疮性肾炎治疗的研究进展

近年来细胞毒类药物、生物制剂、基因工程、骨髓干细胞移植及其它治疗LN药物和方法的研究取得较大进展，以致对LN的疗效进一步提高。     

狼疮性肾炎治疗的研究进展

近年来细胞毒类药物、生物制剂、基因工程、骨髓干细胞移植及其它治疗LN药物和方法的研究取得较大进展 ,以致对LN的疗效进一步提高     

FEN1基因突变在狼疮性肾炎发病机制中的作用

目的 探讨FEN1基因突变在狼疮性肾炎(Lupus nephritis,LN)患者发病机制中的作用.方法 收集43例LN患者和26例健康者的外周血标本,采用全血基因组DNA柱式试剂盒提取DNA,直接PCR方法扩增FEN1基因片段,扩增后PCR产物应用基因测序方法检测FEN1基因序列,并对测序结果与基因数据库中FEN1基因进行比较,搜索可能的突变位点.chi-square检验比较LN患者及健康者FEN1基因突变情况.结果 LN患者正向测序中存在946位碱基C缺失突变(p=0.046).结论 LN患者FEN1基因存在946位碱基C缺失突变.     

High prevalence of anti-C1q antibodies in biopsy-proven active lupus nephritis.

BACKGROUND: Anti-C1q antibodies (anti-C1q) have been shown to correlate positively with systemic lupus erythematosus (SLE) nephritis. Several clinical studies indicated a high negative predictive value, suggesting that active lupus nephritis is rarely seen in patients with no anti-C1q. However, the true prevalence of anti-C1q at the time of active lupus nephritis has not been well established. The aim of this study was to determine prospectively the prevalence of anti-C1q in proven active lupus nephritis at the time of the renal biopsy. METHODS: In this prospective multi-centre study, we investigated adult SLE patients undergoing renal biopsy for suspected active lupus nephritis. Serum samples were taken at the time of the biopsy and analysed for the presence of anti-C1q in a standardized way. The activity of lupus nephritis was classified according to the renal histology. Biopsies were also analysed for the presence of glomerular IgG, C1q and C3 deposition. RESULTS: A total of 38 patients fulfilling at least 4/11 American College of Rheumatology (ACR) criteria for the diagnosis of SLE were included. Out of this, 36 patients had proliferative (class II, III or IV) and two had class V lupus nephritis. All but one patient with proliferative lupus nephritis were positive for anti-C1q (97.2%) compared with the 35% of control SLE patients with inactive lupus nephritis and 25% of SLE patients without lupus nephritis ever. All patients were positive for glomerular C1q (36/36) and 37/38 patients had glomerular IgG deposits. Anti-C1q strongly decreased during successful treatment. CONCLUSIONS: Anti-C1q have a very high prevalence in biopsy-proven active lupus nephritis, thus a negative test result almost excludes active nephritis. The data support the hypothesis of a pathogenic role of anti-C1q in lupus nephritis.     

Anti-ribosomal P antibodies and lupus nephritis

Increasing attention has been paid to the relationship of autoantibodies to ribosomal P proteins (anti-P) with lupus nephritis. Several mechanisms of involvement of anti-P in lupus nephritis have been proposed, including cross-reactivity with anti-dsDNA and anti-endothelial cell antibodies (AECA). In addition, it is also suggested that anti-P might play a role in the development of lupus nephritis through induction of T helper 1 responses. Of note, recent studies have disclosed that the presence of isolated anti-P antibodies may discriminate patients with pure class V lupus nephritis, whereas the simultaneous presence of anti-dsDNA antibodies suggests class V disease with concomitant proliferative lesions. These observations lead to the hypothesis that anti-P and anti-dsDNA might result in membraneous changes and proliferative changes, respectively, although further investigation is required for confirmation.     

Antiphospholipid antibodies in patients with lupus nephritis

The aim of this study was to compare the prevalence of anticardiolipin antibodies with other types of antiphospholipid antibodies (aPL) (antiphosphatidylserine--aPS, antiphosphatidylinositol--aPI, antiphosphatidylethanolamine--aPE) in patients with lupus nephritis and to find if the examination of a panel of various aPL is valuable for further diagnosis of patients. Additionally we determined the levels of autoantibodies against beta2-glycoprotein I (beta2GPI) and oxidized low-density lipoprotein (anti-oxLDL) and also investigated the relationship between antibodies against beta2GPI and oxLDL, which were assessed by ELISA methods. Twenty-two patients with lupus nephritis were studied. The control group consisted of 62 healthy blood donors. A statistically significant higher occurrence of all aPLs in the patients with lupus nephritis in comparison to the control group was found. The prevalence of polyspecific antibodies, which reacted with at least two various phospholipids, was 82% in the group of SLE patients. Significantly higher levels of IgG anti-beta2GPI in the sera of SLE patients (p = 0.0003) was detected. The levels of anti-oxLDL in the sera of the patients group did not differ significantly from the control one. Some positive samples for anti-beta2GPI and negative for aCL or anti-oxLDL and vice versa were found. It ca be concluded that the production of aPL including anti-beta2GPI and anti-oxLDL in the lupus nephritis patients is higher in comparison with healthy blood donors. We assume that the estimation of various types of aPL may be important in the selection of the group patients with renal diseases. The synthesis of aPL can reflect the spreading of the autoimmune response for several antigens modified on the vessel wall.     

T lymphocyte subsets and antilymphocyte antibodies in lupus nephritis

T lymphocyte subsets were determined in 12 patients with untreated systemic lupus erythematosus (SLE) and in 14 healthy controls. Six out of 8 (75%) patients with lupus nephritis had reduction in the percentage of T helper cells and low helper: suppressor cell ratios compared with controls. None of the 4 patients without nephritis had low ratios. Cold-reactive anti-lymphocyte antibodies cytotoxic to both the helper and the suppressor cells were detected in 7 of the 8 patients who had nephritis. Low T helper: suppressor cell ratio in SLE seems to correlate with the presence of active nephritis.     

血管细胞粘附分子在人类狼疮肾炎和新月体肾炎中的表达

利用间接免疫荧光和膜免疫印迹方法，观察了血管细胞粘附分子（ＶＣＡＭ－１）在人类狼疮肾炎和新月体肾炎患者肾组织及血清中的表达。结果表明：狼疮肾炎（Ⅱ、Ⅳ、Ⅴ型）和新月体肾炎患者沿肾小球毛细血管壁可见ＶＣＡＭ－１特异性荧光；肾小球系膜区ＶＣＡＭ－１表达呈现增强的趋势；与轻度系膜增生性肾炎比较，狼疮肾炎（Ⅳ、Ⅱ型）患者血清中ＶＣＡＭ－１水平显著增加（Ｐ＜０．０１）。提示ＶＣＡＭ－１在狼疮肾炎和新月体肾炎的发生发展中可能具有重要作用。