Journal
LUPUS
Volume 24, Issue 1, Pages 42-49Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0961203314547791
Keywords
Anti-dsDNA antibodies; renal lupus; systemic lupus erythematosus
Categories
Funding
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
- Lupus Foundation of America
- Human Genome Sciences
- National Institutes of Health (NIH) [T32 AR048522]
- Greta and Johan Kock's Foundation
- King Gustaf V's 80th Birthday Foundation
- Swedish Rheumatism Association
- Lupus UK
- Canada Research Chair on Systemic Autoimmune Rheumatic Diseases
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
- Korea Healthcare Technology R & D Project, Ministry for Health and Welfare, Republic of Korea [A120404]
- Arthritis Research UK
- Manchester Academic Health Science Centre
- NIHR Manchester Musculoskeletal Biomedical Research Unit
- NIHR Manchester Wellcome Trust Clinical Research Facility
- Manchester Biomedical Research Centre
- National Institute for Health Research [NF-SI-0512-10105] Funding Source: researchfish
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR001422] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [T32AR048522, U01AR051871, R01AR043727, R01AR051871] Funding Source: NIH RePORTER
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Objective Anti-C1q has been associated with systemic lupus erythematosus (SLE) and lupus nephritis in previous studies. We studied anti-C1q specificity for SLE (vs rheumatic disease controls) and the association with SLE manifestations in an international multicenter study. Methods Information and blood samples were obtained in a cross-sectional study from patients with SLE (n=308) and other rheumatologic diseases (n=389) from 25 clinical sites (84% female, 68% Caucasian, 17% African descent, 8% Asian, 7% other). IgG anti-C1q against the collagen-like region was measured by ELISA. Results Prevalence of anti-C1q was 28% (86/308) in patients with SLE and 13% (49/389) in controls (OR=2.7, 95% CI: 1.8-4, p<0.001). Anti-C1q was associated with proteinuria (OR=3.0, 95% CI: 1.7-5.1, p<0.001), red cell casts (OR=2.6, 95% CI: 1.2-5.4, p=0.015), anti-dsDNA (OR=3.4, 95% CI: 1.9-6.1, p<0.001) and anti-Smith (OR=2.8, 95% CI: 1.5-5.0, p=0.01). Anti-C1q was independently associated with renal involvement after adjustment for demographics, ANA, anti-dsDNA and low complement (OR=2.3, 95% CI: 1.3-4.2, p<0.01). Simultaneously positive anti-C1q, anti-dsDNA and low complement was strongly associated with renal involvement (OR=14.9, 95% CI: 5.8-38.4, p<0.01). Conclusions Anti-C1q was more common in patients with SLE and those of Asian race/ethnicity. We confirmed a significant association of anti-C1q with renal involvement, independent of demographics and other serologies. Anti-C1q in combination with anti-dsDNA and low complement was the strongest serological association with renal involvement. These data support the usefulness of anti-C1q in SLE, especially in lupus nephritis.
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