SUMMARYMembrane cofactor protein (MCP, CD46) is a cell surface complement regulatory protein which acts as a cofactor for the factor I-mediated cleavage of the activated complement components C3b/C4b. To evaluate the clinical usefulness of serum soluble CD46 as a marker of disease activity in patients with SLE, serum levels of sCD46 were measured by ELISA, using two MoAbs (M160 and M177), each of which recognized two different epitopes on CD46 molecule in SLE, other autoimmune diseases and healthy controls. Serum sCD46 levels in active SLE patients (30´5 6 14´1 ng/ml) were signi®cantly higher than those of inactive SLE (5´8 6 7´1 ng/ml; P 0´0003), rheumatoid arthritis (14´9 6 11´6 ng/ ml; P 0´0218), primary Sjo Ègren's syndrome (12´3 6 11´6 ng/ml; P 0´0039) and normal controls (7´3 6 3´6 ng/ml; P 0´0005). The elevated serum sCD46 levels in active SLE patients signi®cantly decreased from 30´5 6 14´1 ng/ml to 8´0 6 6´3 ng/ml after effective corticosteroid and immunosuppressant therapy (P 0´018). Additionally, we found a signi®cant negative association between increasing concentration of sCD46 and decreasing levels of CH50 in SLE (r ±0´598, P 0´0009). These results suggest that sCD46 re¯ects in vivo activation of complement system and provides an additional useful serum parameter of active SLE.