title: Association between anti-C1q antibodies and glomerular tuft necrosis in lupus nephritis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Marseille, France. noemie.jourde@ap-hm.fr
authors.forename: Noémie
authors.initials: N
authors.lastname: Jourde-Chiche
authors.forename: Laurent
authors.initials: L
authors.lastname: Daniel
authors.forename: Laurent
authors.initials: L
authors.lastname: Chiche
authors.forename: Stéphane
authors.initials: S
authors.lastname: Burtey
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.forename: Sophie
authors.initials: S
authors.lastname: Jego
authors.forename: Marielle
authors.initials: M
authors.lastname: San Marco
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bardin
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D015922:Complement C1q / Q000276:immunology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000473:pathology; D007678:Kidney Glomerulus / Q000473:pathology*; D008181:Lupus Nephritis / Q000150:complications / Q000276:immunology* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D015922:Complement C1q