Open AccessAntibodies to endothelial cells in systemic lupus erythematosus: a potential marker for nephritis and vasculitis
Author(s) -
D'CRUZ D. P.,
HOUSSIAU F. A.,
RAMIREZ G.,
BAGULEY E.,
McCUTCHEON J.,
VIANNA J.,
HAGA H.J.,
SWANA G. T.,
KHAMASHTA M. A.,
TAYLOR J. C.,
DAVIES D. R.,
HUGHES G. R. V.
Publication year - 1991
Publication title -
clinical & experimental immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 135
eISSN - 1365-2249
pISSN - 0009-9104
DOI - 10.1111/j.1365-2249.1991.tb05714.x
Subject(s) - lupus nephritis , medicine , nephritis , immunology , vasculitis , glomerulonephritis , antibody , proteinuria , renal biopsy , anti neutrophil cytoplasmic antibody , pathology , biopsy , kidney , disease
SUMMARY Using an ELISA, anti‐endothelial cell antibodies (AECA) have been found in sera obtained at the time of renal biopsy in 46 out of 57 patients (81%) with systemic lupus erythematosus (SLE) and nephritis (mean binding index (BI) = 84%± 52.8) compared with 22 out of 50 SLE patients (44%) without nephritis (mean BI = 45%±35.9). Seventy normal human sera had a mean BI of 10%±9.8. The highest levels were seen in patients with diffuse proliferative glomerulonephritis (WHO grade IV) and in patients with proteinuria and nephrotic syndrome. When the biopsies were assessed for activity and chronicity scores, AECA were associated with active renal lesions ( P < 0.001). AECA levels correlated with low complement levels but not with anti‐DN A antibodies to extractable nuclear antigens (ENA), anti‐cardiolipin or anti‐neutrophil cytoplasmic antibodies. The presence of AECA conferred a positive predictive value of 0.68 for the presence of nephritis. Twenty‐five patients had active vasculitis at the time of assay and the highest AECA values were seen in patients with both nephritis and vasculitis. No correlation was seen with serum immunoglobulin levels and immune complexes did not bind significantly to the endothelial surface. The possible role of these antibodies as a marker in lupus nephritis is discussed.