Inserm, Institut national de la santé et de la recherche médicale
Faculté de pharmacie, Aix Marseille Université

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Association between anti-C1q antibodies and glomerular tuft necrosis in lupus nephritis

Jourde-Chiche N, Daniel L, Chiche L, Burtey S, Mancini J, Jego S, San Marco M, Bardin N. Clin Nephrol. 2012 Mar ;77(3):211-8 Impact factor 1.2

Abstract

BACKGROUND :
Proliferative glomerulonephritis includes various glomerular lesions in patients with systemic lupus erythematosus (SLE) that might have distinct pathogenic mechanisms. The aim of the study was to determine whether anti-C1q antibodies, which are associated with lupus nephritis, were specifically associated with given glomerular histopathological lesions.

METHODS :
The presence and titer of anti-C1q antibodies were determined in a retrospective study including 63 SLE patients with biopsy-proven lupus nephritis.

RESULTS :
We confirmed the correlation between the presence of anti-C1q antibodies with both clinical and immunological markers of disease activity. We showed that the presence of anti- C1q antibodies was significantly associated with glomerular tuft necrosis and crescents, major criteria of active lesions. Additionally, no necrosis was found in patients without anti- C1q antibodies, giving anti-C1q antibodies a 100% negative predictive value for glomerular tuft necrosis. Conversely, there was no difference in the percentage of glomeruli showing endocapillary proliferation or wire loops according to the anti-C1q status.

CONCLUSION :
Our data highlight for the first time an association of anti-C1q antibodies with necrotizing forms of lupus nephritis suggesting new insights into the pathogenesis and the treatment of this entity.