Correlation and predictive accuracy of circulating immune complexes with disease activity in patients with systemic lupus erythematosus

Abrass, Christine K.; Nies, Kenneth M.; Louie, James S.; Border, Wayne A.; Glassock, Richard J.

doi:10.1002/art.1780230302

Cited by 133 publications

(54 citation statements)

References 22 publications

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“…Anti-Ro/SSA were determined by counterimmuno-electrophoresis [5]. The level of circulating immune complexes (IgG binding C1q and C3) was determined by an enzyme immunoassay [6]. …”

Section: Methodsmentioning

confidence: 99%

Clinical, Histological and Immunopathological Features of 58 Patients with Subacute Cutaneous Lupus erythematosus

et al. 2000

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Background: Subacute cutaneous lupus erythematosus (SCLE) is a distinct subset of cutaneous lupus erythematosus clinically characterized by psoriasiform and/or annular lesions and by a mild or absent systemic involvement. Objective: The Italian Group of Immunodermatology of the Italian Society of Dermatology and Venereology reviewed the cases of SCLE seen in 10 years (1987–1996). Patients: Forty-six women and 12 men have been retrospectively studied, 42% had annular lesions, 39% psoriasiform ones and 16% both. Results: Lesions were mainly localized on the neck and face and relapsed in spring and autumn. Seventeen patients had 4 or more American College of Rheumatology criteria and could be classified as having systemic lupus erythematosus. The most frequent histopathological alterations were epidermal atrophy, hydropic degeneration of the basal layer and perivascular lymphocytic infiltrate. Deposits of immunoglobulins and C3 at the dermo-epidermal junction on the clinically involved skin were present in 86% of the patients. Dust-like particles in the epidermis were only found in 3% of cases. Anti-Ro/SSA antibodies were found in 71% of the cases and anti-dsDNA only in 5% of cases. Conclusions: SCLE is a particular subset of cutaneous lupus erythematosus with peculiar clinical and immunopathological features.

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“…Anti-Ro/SSA were determined by counterimmuno-electrophoresis [5]. The level of circulating immune complexes (IgG binding C1q and C3) was determined by an enzyme immunoassay [6]. …”

Section: Methodsmentioning

confidence: 99%

Clinical, Histological and Immunopathological Features of 58 Patients with Subacute Cutaneous Lupus erythematosus

et al. 2000

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“…Although serum levels of C3, C4, and their activation-derived products are frequently used to monitor disease activity in SLE, their value as biomark-ers is a subject of controversy (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). These observations have led us to consider measurement of complement activation products bound to circulating blood cells (14,15).…”

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confidence: 99%

Reticulocytes bearing C4d as biomarkers of disease activity for systemic lupus erythematosus

Liu

Manzi

Kao

et al. 2005

Arthritis & Rheumatism

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Objective. There is an urgent need for biomarkers with which to monitor disease activity in patients with systemic lupus erythematosus (SLE). We recently showed that abnormal levels of C4d, an activationderived fragment of complement component C4, are deposited on the surface of erythrocytes from patients with SLE. This study focused on reticulocytes, the youngest and shortest-lived erythrocytes (lifespan 24-48 hours), with the objective of testing our hypothesis that when reticulocytes emerge from the bone marrow, they are immediately exposed to and acquire C4d at levels proportionate to the extent of complement activation at that time, thereby reflecting disease activity in SLE.Methods. We conducted a cross-sectional study of 156 patients with SLE, 140 patients with other diseases, and 159 healthy controls. Levels of C4d on the surface of reticulocytes were examined using a 2-color flow cytometric assay. The results were analyzed for correlations with SLE disease activity.Results. A wide range of increased levels of reticu-

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“…12 Abrass et al claimed a positive predictive value of 82% for disease exacerbation in SLE when the C1qFP went from negative to positive. 19 Coppo et al reported that only 50% of their patients showed an increase in C1qFP prior to clinical exacerbation.…”

Section: Sucrose Density Centrifugationmentioning

confidence: 97%

Measurement of immune complexes is not useful in routine clinical practice

Lock¹,

Unsworth²

2000

Ann Clin Biochem

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The vogue for the determination of immune complexes (ICs) in the clinical setting has now passed, as can be seen from the fact that only two of the regional immunology reference laboratories in the UK still offer a service. This is partly due to the lack of speci®city seen in the assays available, which, apart from minor modi®cations, have remained essentially unchanged. They have not lived up to their initial promise and are unlikely to be offered by service laboratories in the future. In this review we consider when these assays may still have a role and which might be the most useful in a particular clinical setting.An IC is formed when an antibody reacts speci®cally with its corresponding antigen. The size of the complex formed is dependent on many factors, including the ratio of antibody to antigen, the valency of the antigen and the avidity of the antibody±antigen reaction. IC formation is an integral part of the normal immune response to infection and usually takes place without adverse pathological consequences. ICs are captured by speci®c receptors, in particular on erythrocytes, and transported to the reticuloendothelial system for processing and removal. The events leading to IC formation and subsequent removal are summarized in Fig. 1. There are, however, various disorders in which ICs play an important role in the disease process. These include some forms of vasculitis (e.g. Henoch±SchoÈ nlein purpura), infectious disorders (e.g. bacterial endocarditis, shunt nephritis) and connective tissue autoimmune disorders [e.g. rheumatoid arthritis (RA), systemic lupus erythematosus (SLE)]. The pathology generally arises from inappropriate clearance or deposition of ICs. Thus, vasculitis DETECTION OF CIC IN BODY FLUIDS (USUALLY SERUM)At least 40 different assays for CICs have been described. They vary widely in terms of disease sensitivity, speci®city and clinical applicability. Possibly the major area of investigation has been in autoimmune disease, in particular SLE. SLE has been considered the archetypal IC disease. Many of the disease manifestations, including

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Correlation and predictive accuracy of circulating immune complexes with disease activity in patients with systemic lupus erythematosus

Cited by 133 publications

References 22 publications

Clinical, Histological and Immunopathological Features of 58 Patients with Subacute Cutaneous Lupus erythematosus

Clinical, Histological and Immunopathological Features of 58 Patients with Subacute Cutaneous Lupus erythematosus

Reticulocytes bearing C4d as biomarkers of disease activity for systemic lupus erythematosus

Measurement of immune complexes is not useful in routine clinical practice

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