İstanbul Tıp Fakültesi Dergisi

GÖNDERBİLGİ
EnglishTürkçe

Araştırma Makalesi


DOI :10.26650/IUITFD.1464651   IUP :10.26650/IUITFD.1464651    Tam Metin (PDF)

SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ

Senem Tekeoğlu, Duygu Temiz Karadağ, Özlem Özdemir Işık, Aylin Göçoğlu, Fatma Ceyla Eraldemir, Ayten Yazıcı, Ayşe Çefle

Amaç: Lupus nefriti (LN), sistemik lupus eritematozus'un (SLE) tehlikeli bir sonucudur. Çeşitli çalışmalarda anti-C1q antikorunun LN veya global hastalık aktivitesi ile ilişkili olduğu gösterilmiştir. Bu çalışmada amacımız, Türk SLE’li hastalarda anti-C1q prevalansını, LN veya hastalık aktivitesi ile ilişkisini belirlemekti.

Gereç ve Yöntem: Kesitsel tek merkezli bir çalışma ile 150 SLE’li hastada klinik ve laboratuvar bulguları, hastalık aktivitesi ve anti-C1q düzeyleri değerlendirildi. Anti-C1q antikoru, ELISA (enzyme-linked immunosorbent assay) ile analiz edildi, toplam 150 kişiden oluşan hasta ve sağlıklı kontrol grubu ile karşılaştırıldı.

Bulgular: Yetmiş iki hastada LN’i saptandı. Anti-C1q pozitiflik oranı SLE hastalarında %17 (26/150), kontrol grubunda ise %3 (5/150) idi (p<0,001). Anti-C1q antikoru pozitif olan hastalarda aynı zamanda pozitif anti-Sm antikoru, direkt Coombs testi ve trombositopeni de daha sık görüldü (sırasıyla p=0,001, p=0,007, p=0,009). Anti-C1q antikoru proteinüri, hematüri, sistemik lupus eritematoz hastalık aktivite indeksi (SLEDAI) (p<0,001), anti-dsDNA (p=0,03) ile pozitif, C3 (p<0,001) ve C4 (p=0,015) ile negatif korelasyon gösterdi. Aktif LN'li hastalarda anti-C1q (p=0,01) ve anti-dsDNA (p<0,001) titreleri inaktif LN hastalarına göre daha yüksekti, ancak çok değişkenli lojistik regresyon analizinde anti-C1q LN öyküsü için anlamlı değildi. SLEDAI şiddeti açısından anlamlılık saptandı (p=0,036).

Sonuç: Çalışmamız anti-C1q antikorunun SLE, proteinüri, hematüri, trombositopeni, genel hastalık aktivitesi ve aktif LN ile anlamlı bir ilişkisi olduğunu, ancak inaktif böbrek hastalığı ile ilişkili olmadığını kanıtladı. Çalışmamız, bu antikorun Türk SLE’li hastalarda klinik önemini araştıran ilk araştırmadır. Lupus nefritinin patogenezini açıklığa kavuşturmak için daha ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Anti-C1q, lupus nefriti, sistemik lupus eritematozus, sistemik lupus eritematozus hastalık aktivite indeksi
DOI :10.26650/IUITFD.1464651   IUP :10.26650/IUITFD.1464651    Tam Metin (PDF)

ANTI-C1q IN SYSTEMIC LUPUS ERYTHEMATOSUS: RELATIONSHIP WITH CLINICAL MANIFESTATIONS AND DISEASE ACTIVITY

Senem Tekeoğlu, Duygu Temiz Karadağ, Özlem Özdemir Işık, Aylin Göçoğlu, Fatma Ceyla Eraldemir, Ayten Yazıcı, Ayşe Çefle

Objective: Lupus nephritis (LN) is a detrimental consequence of systemic lupus erythematosus (SLE). The anti-C1q antibody was shown to be related to LN, or global disease activity, in various studies. Our purpose was to determine its prevalence and association with LN or disease activity in Turkish patients with SLE.

Material and Method: We conducted a cross-sectional single-centre study to investigate the clinical and laboratory findings, disease activity, and anti-C1q levels in 150 patients with SLE. The anti-C1q antibody was analyzed using an enzyme-linked immunosorbent assay and compared with 150 healthy-control patients.

Result: Lupus nephritis was present in 72 patients. The frequency of anti-C1q positivity was 17% (26/150) in patients with SLE and 3% (5/150) in control group (p<0.001). Patients with anti-C1q also had anti-Sm, direct Coombs’ test, and thrombocytopenia more commonly (p=0.001, p=0.007, p=0.009 respectively). Anti-C1q was positively correlated with proteinuria, haematuria, systemic lupus erythematosus disease activity index (SLEDAI) (p<0.001), anti-dsDNA (p=0.03), and negatively correlated with C3 (p<0.001) and C4 (p=0.015). Patients with active LN had higher anti-C1q (p=0.01) and anti-dsDNA (p<0.001) titres than inactive LN patients, although in multivariate logistic regression analysis, anti-C1q was not significant for LN history. It was significant for SLEDAI severity (p=0.036).

Conclusion: Our study demonstrated a significant association of anti-C1q with SLE, proteinuria, haematuria, thrombocytopenia, general disease activity, and active LN, but not with inactive renal disease. This is the first study investigating the clinical significance of this antibody in Turkish patients. Further studies are needed to clarify the pathogenesis of lupus nephritis.

Anahtar Kelimeler: Anti-C1q, systemic lupus erythematosus, lupus nephritis, systemic lupus erythematosus disease activity index

PDF Görünüm

Referanslar

  • Morales E, Galindo M, Trujillo H, Praga M. Update on lupus nephritis: Looking for a New Vision. Nephron 2021;145(1):1-13. [CrossRef] google scholar
  • Bomback AS. An Update on therapies for proliferative Lupus Nephritis: How Certain Can We Be About the Evidence? Am J Kidney Dis 2018;72(5):758-60. [CrossRef] google scholar
  • Caster DJ, Powell DW. Utilization of Biomarkers in Lupus Nephritis. Adv Chronic Kidney Dis 2019;26(5):351-9. [CrossRef] google scholar
  • Olson SW, Lee JJ, Prince LK, Baker TP, Papadopoulos P, Edison J, et al. Elevated subclinical double-stranded DNA antibodies and future proliferative lupus nephritis. Clin J Am Soc Nephrol 2013;8(10):1702-8. [CrossRef] google scholar
  • Rovin BH, Zhang X. Biomarkers for lupus nephritis: the quest continues. Clin J Am Soc Nephrol 2009;4(11):1858-65. [CrossRef] google scholar
  • Thielens NM, Tedesco F, Bohlson SS, Gaboriaud C, Tenner AJ. C1q: A fresh look upon an old molecule. Mol Immunol 2017;89:73-83. [CrossRef] google scholar
  • Orbai AM, Truedsson L, Sturfelt G, Nived O, Fang H, Alarcon GS, et al. Anti-C1q antibodies in systemic lupus erythematosus. Lupus 2015;24(1):42-9. [CrossRef] google scholar
  • Moroni G, Radice A, Giammarresi G, Quaglini S, Gallelli B, Leoni A, et al. Are laboratory tests useful for monitoring the activity of lupus nephritis? A 6-year prospective study in a cohort of 228 patients with lupus nephritis. Ann Rheum Dis 2009;68(2):234-7. [CrossRef] google scholar
  • Akhter E, Burlingame RW, Seaman AL, Magder L, Petri M. Anti-C1q antibodies have higher correlation with flares of lupus nephritis than other serum markers. Lupus 2011;20(12):1267-74. [CrossRef] google scholar
  • Matrat A, Veysseyre-Balter C, Trolliet P, Villar E, Dijoud F, Bienvenu J, et al. Simultaneous detection of anti-C1q and anti-double stranded DNA autoantibodies in lupus nephritis: predictive value for renal flares. Lupus 2011;20(1):28-34. [CrossRef] google scholar
  • Julkunen H, Ekblom-Kullberg S, Miettinen A. Nonrenal and renal activity of systemic lupus erythematosus: a comparison of two anti-C1q and five anti-dsDNA assays and complement C3 and C4. Rheumatol Int 2012;32(8):2445-51. [CrossRef] google scholar
  • Yang XW, Tan Y, Yu F, Zhao MH. Combination of anti-C1q and anti-dsDNA antibodies is associated with higher renal disease activity and predicts renal prognosis of patients with lupus nephritis. Nephrol Dial Transplant 2012;27(9):3552-9. [CrossRef] google scholar
  • Katsumata Y, Miyake K, Kawaguchi Y, Okamoto Y, Kawamoto M, Gono T, et al. Anti-C1q antibodies are associated with systemic lupus erythematosus global activity but not specifically with nephritis: a controlled study of 126 consecutive patients. Arthritis Rheum 2011;63(8):2436-44. [CrossRef] google scholar
  • Yin Y, Wu X, Shan G, Zhang X. Diagnostic value of serum anti-C1q antibodies in patients with lupus nephritis: a meta-analysis. Lupus 2012;21(10):1088-97. [CrossRef] google scholar
  • Eggleton P, Ukoumunne OC, Cottrell I, Khan A, Maqsood S, Thornes J, et al. Autoantibodies against C1q as a Diagnostic Measure of Lupus Nephritis: Systematic Review and Meta-analysis. J Clin Cell Immunol 2014;22;5(2):210. google scholar
  • Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40(9):1725. [CrossRef] google scholar
  • Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012;64(8):2677-86. [CrossRef] google scholar
  • Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002;29(2):288-91. google scholar
  • Weening JJ, D’Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, et al. International Society of Nephrology Working Group on the Classification of Lupus Nephritis; Renal Pathology Society Working Group on the Classification of Lupus Nephritis. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int 2004;65(2):521-30. [CrossRef] google scholar
  • Mok CC, Teng YKO, Saxena R, Tanaka Y. Treatment of lupus nephritis: consensus, evidence and perspectives. Nat Rev Rheumatol 2023;19(4):227-38. [CrossRef] google scholar
  • Tunnicliffe DJ, Singh-Grewal D, Kim S, Craig JC, Tong A. Diagnosis, Monitoring, and Treatment of Systemic Lupus Erythematosus: A Systematic Review of Clinical Practice Guidelines. Arthritis Care Res (Hoboken) 2015;67(10):1440-52. [CrossRef] google scholar
  • Tsokos GC. Autoimmunity and organ damage in systemic lupus erythematosus. Nat Immunol 2020;21(6):605-14. [CrossRef] google scholar
  • Weinstein A, Alexander RV, Zack DJ. A Review of Complement Activation in SLE. Curr Rheumatol Rep 2021;10;23(3):16. [CrossRef] google scholar
  • Lewis MJ, Jawad AS. The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus. Rheumatology (Oxford) 2017;1;56(suppl_1):i67-i77. google scholar
  • Oelzner P, Deliyska B, Fünfstück R, Hein G, Herrmann D, Stein G. Anti-C1q antibodies and antiendothelial cell antibodies in systemic lupus erythematosus-relationship with disease activity and renal involvement. Clin Rheumatol 2003;22(4-5):271-8. [CrossRef] google scholar
  • Grootscholten C, Dieker JW, McGrath FD, Roos A, Derksen RH, van der Vlag J, et al A prospective study of anti-chromatin and anti-C1q autoantibodies in patients with proliferative lupus nephritis treated with cyclophosphamide pulses or azathioprine/methylprednisolone Ann Rheum Dis 2007;66(5):693-6 [CrossRef] google scholar
  • Jaekell HP, Trabandt A, Grobe N, Werle E Anti-dsDNA antibody subtypes and anti-C1q antibodies: toward a more reliable diagnosis and monitoring of systemic lupus erythematosus and lupus nephritis Lupus 2006;15(6):335-45 [CrossRef] google scholar
  • Armstrong DJ, Crockard AD, Whitehead EM, Bell AL Anti-C1q antibodies in renal and non-renal SLE Ann Rheum Dis 2005;64(7):1108 google scholar
  • Horvâth L, Czirjâk L, Fekete B, Jakab L, Pozsonyi T, Kalabay L, et al High levels of antibodies against Clq are associated with disease activity and nephritis but not with other organ manifestations in SLE patients Clin Exp Rheumatol 2001;19(6):667-72 google scholar
  • Marto N, Bertolaccini ML, Calabuig E, Hughes GR, Khamashta MA Anti-C1q antibodies in nephritis: correlation between titres and renal disease activity and positive predictive value in systemic lupus erythematosus Ann Rheum Dis 2005;64(3):444-8 [CrossRef] google scholar
  • Rodrîguez-Almaraz E, Gutierrez-Solıs E, Rabadân E, Rodrîguez P, Carmona L, Morales E, et al . Something new about prognostic factors for lupus nephritis? A systematic review. Lupus 2021;30(14):2256-67. [CrossRef] google scholar
  • Guimarâes JAR, Furtado SDC, Lucas ACDS, Mori B, Barcellos JFM. Diagnostic test accuracy of novel biomarkers for lupus nephritis-An overview of systematic reviews. PLoS One 2022;10;17(10):e0275016. [CrossRef] google scholar

Atıflar

Biçimlendirilmiş bir atıfı kopyalayıp yapıştırın veya seçtiğiniz biçimde dışa aktarmak için seçeneklerden birini kullanın


DIŞA AKTAR



APA

Tekeoğlu, S., Temiz Karadağ, D., Özdemir Işık, Ö., Göçoğlu, A., Eraldemir, F.C., Yazıcı, A., & Çefle, A. (2024). SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ. İstanbul Tıp Fakültesi Dergisi, 87(4), 311-320. https://doi.org/10.26650/IUITFD.1464651


AMA

Tekeoğlu S, Temiz Karadağ D, Özdemir Işık Ö, Göçoğlu A, Eraldemir F C, Yazıcı A, Çefle A. SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ. İstanbul Tıp Fakültesi Dergisi. 2024;87(4):311-320. https://doi.org/10.26650/IUITFD.1464651


ABNT

Tekeoğlu, S.; Temiz Karadağ, D.; Özdemir Işık, Ö.; Göçoğlu, A.; Eraldemir, F.C.; Yazıcı, A.; Çefle, A. SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ. İstanbul Tıp Fakültesi Dergisi, [Publisher Location], v. 87, n. 4, p. 311-320, 2024.


Chicago: Author-Date Style

Tekeoğlu, Senem, and Duygu Temiz Karadağ and Özlem Özdemir Işık and Aylin Göçoğlu and Fatma Ceyla Eraldemir and Ayten Yazıcı and Ayşe Çefle. 2024. “SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ.” İstanbul Tıp Fakültesi Dergisi 87, no. 4: 311-320. https://doi.org/10.26650/IUITFD.1464651


Chicago: Humanities Style

Tekeoğlu, Senem, and Duygu Temiz Karadağ and Özlem Özdemir Işık and Aylin Göçoğlu and Fatma Ceyla Eraldemir and Ayten Yazıcı and Ayşe Çefle. “SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ.” İstanbul Tıp Fakültesi Dergisi 87, no. 4 (Nov. 2024): 311-320. https://doi.org/10.26650/IUITFD.1464651


Harvard: Australian Style

Tekeoğlu, S & Temiz Karadağ, D & Özdemir Işık, Ö & Göçoğlu, A & Eraldemir, FC & Yazıcı, A & Çefle, A 2024, 'SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ', İstanbul Tıp Fakültesi Dergisi, vol. 87, no. 4, pp. 311-320, viewed 14 Nov. 2024, https://doi.org/10.26650/IUITFD.1464651


Harvard: Author-Date Style

Tekeoğlu, S. and Temiz Karadağ, D. and Özdemir Işık, Ö. and Göçoğlu, A. and Eraldemir, F.C. and Yazıcı, A. and Çefle, A. (2024) ‘SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ’, İstanbul Tıp Fakültesi Dergisi, 87(4), pp. 311-320. https://doi.org/10.26650/IUITFD.1464651 (14 Nov. 2024).


MLA

Tekeoğlu, Senem, and Duygu Temiz Karadağ and Özlem Özdemir Işık and Aylin Göçoğlu and Fatma Ceyla Eraldemir and Ayten Yazıcı and Ayşe Çefle. “SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ.” İstanbul Tıp Fakültesi Dergisi, vol. 87, no. 4, 2024, pp. 311-320. [Database Container], https://doi.org/10.26650/IUITFD.1464651


Vancouver

Tekeoğlu S, Temiz Karadağ D, Özdemir Işık Ö, Göçoğlu A, Eraldemir FC, Yazıcı A, Çefle A. SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ. İstanbul Tıp Fakültesi Dergisi [Internet]. 14 Nov. 2024 [cited 14 Nov. 2024];87(4):311-320. Available from: https://doi.org/10.26650/IUITFD.1464651 doi: 10.26650/IUITFD.1464651


ISNAD

Tekeoğlu, Senem - Temiz Karadağ, Duygu - Özdemir Işık, Özlem - Göçoğlu, Aylin - Eraldemir, FatmaCeyla - Yazıcı, Ayten - Çefle, Ayşe. “SİSTEMİK LUPUS ERİTEMATOZUSTA ANTİ-C1q: KLİNİK BULGULAR VE HASTALIK AKTİVİTESİ İLE İLİŞKİSİ”. İstanbul Tıp Fakültesi Dergisi 87/4 (Nov. 2024): 311-320. https://doi.org/10.26650/IUITFD.1464651



ZAMAN ÇİZELGESİ


Gönderim05.04.2024
Kabul07.06.2024
Çevrimiçi Yayınlanma10.10.2024

LİSANS


Attribution-NonCommercial (CC BY-NC)

This license lets others remix, tweak, and build upon your work non-commercially, and although their new works must also acknowledge you and be non-commercial, they don’t have to license their derivative works on the same terms.


PAYLAŞ




İstanbul Üniversitesi Yayınları, uluslararası yayıncılık standartları ve etiğine uygun olarak, yüksek kalitede bilimsel dergi ve kitapların yayınlanmasıyla giderek artan bilimsel bilginin yayılmasına katkıda bulunmayı amaçlamaktadır. İstanbul Üniversitesi Yayınları açık erişimli, ticari olmayan, bilimsel yayıncılığı takip etmektedir.