title: Co-Positivity for Anti-dsDNA, -Nucleosome and -Histone Antibodies in Lupus Nephritis Is Indicative of High Serum Levels and Severe Nephropathy.
abstract: OBJECTIVE
  To characterize the significance of correlated autoantibodies in systemic lupus erythematosus (SLE) and its complication lupus nephritis (LN) in a large cohort of patients.
  
  
  METHODS
  Clinical data were statistically analyzed in 1699 SLE patients with or without nephritis who were diagnosed and treated during 2002-2013 in the northeast region of China. Reactivity to a list of 16 autoantibodies was detected by the serum test Euroline ANA profile (IgG). Serum titers of the anti-nucleosome autoantibodies were measured by ELISA assays. Kidney biopsies were examined by pathologists. Immune complex deposition was identified by immunohistochemistry stain.
  
  
  RESULTS
  Simultaneous positivity of anti-dsDNA, -nucleosome and -histone antibodies (3-pos) was prevalent in SLE patients with LN compared to Non-renal SLE patients (41% vs 11%, p< 0.001). Significant correlations were found between any two of the above three anti-nucleosome antibodies in LN patients. In comparison to non-3-pos cohorts, 3-pos patients with LN had significantly higher serum levels of the three antibodies and more active disease; was associated with type IV disease; suffered from more severe renal damages; received more intensive treatment and had worse disease outcome. The serum levels of these three autoantibodies in 3-pos LN patients were significantly decreased when they underwent clinical recovery.
  
  
  CONCLUSIONS
  Simultaneous reactivity to anti-dsDNA, -nucleosome and -histone antibodies by Euroline ANA profile (IgG) may indicate severe nephropathy in patients with SLE.
authors.affiliation: Dept. of Immunology, Harbin Medical University, 150081 Harbin, China; Immunity & Infection Key laboratory of Heilongjiang Province, 150081 Harbin, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Yang
authors.affiliation: Dept. of Clinical Laboratory Medicine, First Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Zhaozhen
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Dept. of Nephrology, First Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Manshu
authors.initials: M
authors.lastname: Sui
authors.affiliation: Dept. of General Surgery, First Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Jihua
authors.initials: J
authors.lastname: Han
authors.affiliation: Dept. of Immunology, Harbin Medical University, 150081 Harbin, China; Immunity & Infection Key laboratory of Heilongjiang Province, 150081 Harbin, China.
authors.forename: Lijie
authors.initials: L
authors.lastname: Sun
authors.affiliation: Dept. of Immunology, Harbin Medical University, 150081 Harbin, China; Immunity & Infection Key laboratory of Heilongjiang Province, 150081 Harbin, China.
authors.forename: Xiuzhi
authors.initials: X
authors.lastname: Jia
authors.affiliation: Dept. of Epidemiology and Biostatistics, Harbin Medical University, Harbin 150081, China.
authors.forename: Haiyu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Dept. of Pathology, Harbin Medical University, 150081 Harbin, China.
authors.forename: Changsong
authors.initials: C
authors.lastname: Han
authors.affiliation: Dept. of Pathology, Harbin Medical University, 150081 Harbin, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Jin
authors.affiliation: Dept. of Clinical Laboratory Medicine, Second Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.affiliation: Dept. of Clinical Laboratory Medicine, Second Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Dept. of Rheumatology, Second Hospital Affiliated to Harbin Medical University, 150001 Harbin, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Harbin center for disease control and prevention, 150081 Harbin, China.
authors.forename: Jianbin
authors.initials: J
authors.lastname: Cao
authors.affiliation: Dept. of Microbiology, Harbin Medical University, 150081 Harbin, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ling
authors.affiliation: Dept. of Microbiology, Harbin Medical University, 150081 Harbin, China.
authors.forename: Fengmin
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Dept. of Immunology, Harbin Medical University, 150081 Harbin, China; Immunity & Infection Key laboratory of Heilongjiang Province, 150081 Harbin, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001706:Biopsy; D002648:Child; D002681:China; D004247:DNA / Q000097:blood / Q000276:immunology*; D005260:Female; D006657:Histones / Q000097:blood / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000473:pathology; D008181:Lupus Nephritis / Q000097:blood / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009707:Nucleosomes / Q000276:immunology* / Q000473:pathology
chemical_list: D001323:Autoantibodies; D006657:Histones; D009707:Nucleosomes; D004247:DNA