Anti-erythropoietin receptor antibodies in systemic lupus erythematosus patients with anemia.
Anemia is a common hematologic abnormality in systemic lupus erythematosus (SLE). An inadequate erythropoietin (EPO) response in SLE patients with anemia has been described that may be due to the presence of antibodies to EPO in SLE patients. However, whether anemia in patients with SLE is related to antibodies to EPO receptor (EPOR) has not yet been investigated. We enlisted 169 consecutive patients with SLE and 45 normal individuals to investigate the existence and importance of circulating autoantibodies to EPOR in sera from patients with SLE. In all patients with SLE, the disease activity was evaluated by using the SLE disease activity index SLEDAI. Anti-EPOR antibodies were detected by using an enzyme-linked immunosorbent assay (ELISA). A higher frequency of anti-EPOR antibodies was observed in SLE patients than in healthy controls (18.3% vs 2.2%, p = 0.007). Moreover, anti-EPOR antibodies were detected in 22 of 69 (31.9%) SLE patients with anemia and in only nine of 100 (9.0%, p < 0.001) in those without. Furthermore, the patients with anti-EPOR antibodies exhibited more severe anemia and often presented as microcytic anemia (p = 0.001). Finally, anti-EPOR antibodies seemed more likely to occur in patients with rash (p = 0.008), lower levels of C(3) component (p = 0.01), higher titer of anti-dsDNA antibodies (p < 0.001) and higher disease activity scores (p = 0.024). The results of this study suggest that anti-EPOR antibodies might play a vital role in SLE patients developing anemia because of the higher incidence of antibodies to EPOR found in SLE patients with anemia. Thus, there might be clinical value in detecting anti-EPOR antibodies in SLE patients with anemia. Therefore, the pathologic role of the antibodies in inducing anemia needs to be established in future studies.
Department of Rheumatology and Immunology, West China Hospital, Sichuan University, 37 Guoxue Lane, PR China.
X-Y
XY
Luo
M-H
MH
Yang
Ping
P
Peng
L-J
LJ
Wu
Q-S
QS
Liu
L
L
Chen
Z
Z
Tang
N-T
NT
Liu
X-F
XF
Zeng
Y
Y
Liu
G-H
GH
Yuan
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000276:immunology*; D001323:Autoantibodies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017467:Receptors, Erythropoietin / Q000276:immunology*; D055815:Young Adult
D001323:Autoantibodies; D017467:Receptors, Erythropoietin