title: Antibodies to C1q in systemic lupus erythematosus: characteristics and relation to Fc gamma RIIA alleles.
abstract: Autoantibodies to the collagen-like region of the first complement component (C1qAB) are found in patients with systemic lupus erythematosus (SLE), particularly those with renal disease. In a cohort of 46 SLE patients with diffuse proliferative glomerulonephritis, we found declining C1qAB titers in 77% of treatment responders and in only 38% of treatment non-responders (P < 0.03). To further characterize this autoantibody, we tested 240 SLE patients for the presence of C1qAB. Positive titers were found in 44% of patients with renal disease and 18% of patients without renal disease (chi2 P < 0.0003). Analysis of IgG subclass revealed IgG2 C1qAB alone in 34%, IgG1 C1qAB alone in 20%, and both IgG1 and IgG2 in 46% of patients. Fewer than 10% of patients had measurable titers of IgG3 or IgG4 C1qAB. The pathogenic role of these IgG2-skewed C1qAB may relate to impaired immune complex clearance by the mononuclear phagocyte system: IgG2 antibodies are efficiently recognized by only one IgG receptor, the H131 allele of Fc gamma RIIa (Fc gamma RIIa-H131). In contrast, Fc gamma RIIa-R131, which is characterized by minimal IgG2 binding, has recently been associated with lupus nephritis. In our C1qAB positive patients, the presence of Fc gamma RIIA-R131 was associated with an increased risk for renal disease. Autoantibodies to C1q may have pathogenic significance in SLE patients with genetic defects in the ability to clear IgG2 containing immune complexes.
authors.affiliation: Department of Medicine, Hospital for Special Surgery, Cornell University Medical College, New York, New York, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Haseley
authors.forename: J J
authors.initials: JJ
authors.lastname: Wisnieski
authors.forename: M R
authors.initials: MR
authors.lastname: Denburg
authors.forename: A R
authors.initials: AR
authors.lastname: Michael-Grossman
authors.forename: E M
authors.initials: EM
authors.lastname: Ginzler
authors.forename: M F
authors.initials: MF
authors.lastname: Gourley
authors.forename: J H
authors.initials: JH
authors.lastname: Hoffman
authors.forename: R P
authors.initials: RP
authors.lastname: Kimberly
authors.forename: J E
authors.initials: JE
authors.lastname: Salmon
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D001323:Autoantibodies / Q000097:blood* / Q000145:classification; D015922:Complement C1q / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017452:Receptors, IgG / Q000235:genetics*
chemical_list: D001323:Autoantibodies; D017452:Receptors, IgG; D015922:Complement C1q