title: Simultaneous positivity for anti-DNA, anti-nucleosome and anti-histone antibodies is a marker for more severe lupus nephritis.
abstract: OBJECTIVE
  The purpose of this study is to examine autoantibody profile of systemic lupus erythematosus (SLE) patients with lupus nephritis (LN) and to establish the correlation between the antibody reactivity and disease activity of LN.
  
  
  METHODS
  Autoantibodies and serological parameters were measured and analyzed in 589 SLE patients. The associations of the co-positivity of anti-dsDNA, -nucleosome and -histone antibodies (3-pos) with clinical, serological and outcome parameters were analyzed.
  
  
  RESULTS
  At the study entry, the prevalence for anti-dsDNA (61.52 % vs. 34.11 %, P < 0.0001), anti-nucleosome (56.09 % vs. 37.21 %, P = 0.0002) and anti-histone (49.35 % vs. 33.33 %, P = 0.0013) antibodies in patients with LN were significantly higher than that in patients without LN. Patients with 3-pos had a higher proportion of proliferative renal lesions (class III + IV). The incidence of a poor renal outcome (7.14 % vs. 2.52 %, P = 0.0174) in LN patients with 3-pos was significantly higher than those without 3-pos. Moreover, the rate of remission (73.63 % vs. 82.37 %, P = 0.0245) was significantly reduced and recurrence increased (58.90 % vs. 23.44 %, P < 0.0001) in 3-pos patients as compared to that in non 3-pos within the LN group.
  
  
  CONCLUSIONS
  Our data indicate a strong association between the 3-pos and renal disease activities, especially proliferative glomerulonephritis. The ability of 3-pos to predict renal flares may lead to major additional benefits in the follow-up of these patients.
authors.affiliation: Department of Nephrology, First Hospital Affiliated to Harbin Medical University, 150001, Harbin, China.
authors.forename: Manshu
authors.initials: M
authors.lastname: Sui
authors.forename: Mansu
authors.initials: M
authors.lastname: Sui
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Lin
authors.forename: Zhaozhen
authors.initials: Z
authors.lastname: Xu
authors.forename: Xiaojing
authors.initials: X
authors.lastname: Han
authors.forename: Rujuan
authors.initials: R
authors.lastname: Xie
authors.forename: Xiuzhi
authors.initials: X
authors.lastname: Jia
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Guo
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhang
authors.forename: Xiuru
authors.initials: X
authors.lastname: Guan
authors.forename: Huan
authors.initials: H
authors.lastname: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000276:immunology / Q000473:pathology; D006657:Histones / Q000276:immunology*; D006801:Humans; D008181:Lupus Nephritis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009707:Nucleosomes / Q000276:immunology*; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D015415:Biomarkers; D006657:Histones; D009707:Nucleosomes