title: Associations of the Levels of C4d-bearing Reticulocytes and High-avidity Anti-dsDNA Antibodies with Disease Activity in Systemic Lupus Erythematosus.
abstract: There are no laboratory tools that detect early flares in systemic lupus erythematosus (SLE). Our aim was to validate in our population the previous findings of the association of C4d-bearing reticulocytes (R-C4d) compared to anti-dsDNA antibodies, with disease activity assessed by the Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and the British Isles Lupus Assessment Group (BILAG) 2004 scales.
  
  
  
  All patients who met the 1987 American College of Rheumatology classification criteria and were seen consecutively in 2013 at a specialized SLE care clinic were included. Disease activity was established by the SELENA-SLEDAI and BILAG 2004. Anti-dsDNA and R-C4d were quantified in peripheral blood. Comparisons were made between values of active and inactive patients, and the correlations between the SELENA-SLEDAI and serum levels of anti-dsDNA and R-C4d were measured.
  
  
  
  Sixty-two patients (83.9% women) were included. A total of 32.3% had active disease according to the SELENA-SLEDAI. There was a significant statistical difference (p = 0.0001) in the distribution of R-C4d between disease activity groups. The correlation coefficient between R-C4d and the SELENA-SLEDAI score was rs = 0.738 (p = 0.0001). R-C4d differed between patients with and without activity in the BILAG 2004 constitutional, mucocutaneous, gastrointestinal, renal, and hematological domains.
  
  
  
  R-C4d showed a higher correlation with SLE activity measured by the SELENA-SLEDAI and BILAG 2004 than anti-dsDNA did, suggesting a possible involvement in diagnosing disease activity. Prospective studies that confirm these findings and evaluate its involvement in followup are needed.
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mora
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Jorge
authors.initials: J
authors.lastname: Medina-Rosas
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Santos
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Diego A
authors.initials: DA
authors.lastname: Jaimes
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Arbeláez
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Romero
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana.
authors.forename: Annie
authors.initials: A
authors.lastname: Cortes
authors.affiliation: From the Department of Rheumatology and Immunology, University of La Sabana, Chía; and the Laboratory of Immunology, Hospital Militar Central, Bogotá, Colombia.C. Mora, MD, MSc, University of La Sabana; J. Medina-Rosas, MD, MSc, University of La Sabana; A.M. Santos, PhD, University of La Sabana; D.A. Jaimes, MD, MSc, University of La Sabana; A.M. Arbeláez, MD, MSc, University of La Sabana; C. Romero, PhD, Hospital Militar Central; A. Cortes, MsC, University of La Sabana; J. Londono, MD, MSc, PhD, University of La Sabana. johnlp@unisabana.edu.co.
authors.forename: John
authors.initials: J
authors.lastname: Londono
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D015704:CD4 Antigens / Q000378:metabolism*; D004247:DNA / Q000276:immunology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012156:Reticulocytes / Q000276:immunology*; D012720:Severity of Illness Index
chemical_list: D000974:Antibodies, Antinuclear; D015704:CD4 Antigens; D004247:DNA
keywords: BIOLOGICAL MARKERS; CD ANTIGENS; DISEASE ACTIVITY; SLEDAI; SYSTEMIC LUPUS ERYTHEMATOSUS; SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY INDEX