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Lupus, Vol. 16, No. 6, 394-400 (2007)
DOI: 10.1177/0961203307078391

Autoantibodies in lupus nephritis patients requiring renal transplantation

L.M. Stinton

Department of Medicine; University of Calgary, Calgary, Alberta, Canada

S.G. Barr

Department of Medicine; University of Calgary, Calgary, Alberta, Canada

L.A. Tibbles

Department of Medicine; University of Calgary, Calgary, Alberta, Canada, Department of Physiology and Biophysics; University of Calgary, Calgary, Alberta, Canada

S. Yilmaz

Department of Surgery, University of Calgary, Calgary, Alberta, Canada

A. Sar

Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

H. Benedikttson

Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada

M.J. Fritzler

Department of Medicine; University of Calgary, Calgary, Alberta, Canada, fritzler{at}ucalgary.ca

The goal of this nested case-control study was to compare autoantibody profiles in systemic lupus erythematosus (SLE) patients with lupus nephritis (LN), lupus nephritis patients requiring renal transplantation (LNTP) and a SLE control group without nephritis (CON). Sera were assayed for a variety of autoantibodies by addressable laser bead immunoassay (ALBIA) and enzyme-linked immunoassay (ELISA) and to dsDNA by Crithidia luciliae assay. The frequency of nucleosome autoantibodies was significantly greater in the LNTP group (79%) compared to the LN (18%) and CON (9%) groups (P < 0.0005). The frequency of other autoantibodies, including anti-dsDNA, did not differ significantly between groups. Among patients with LN, the odds of progressing to renal transplantation was 16-fold higher (OR 16.5 [95% CI 2.5, 125.7], P = 0.0005) in patients testing positive for anti-nucleosome antibodies compared to those who tested negative. Furthermore, the level of anti-nucleosome antibodies was significantly ( P < 0.00005) higher in the LNTP group (3.69 ± 2.79) than the LN (0.51 ± 0.51) and CON (0.34 ± 0.44) groups. Review of 48 renal biopsies from 29 patients indicated that there was no difference in renal histological classification among patients with anti-nucleosome antibodies compared to those who tested negative. Our observations suggest that nucleosome autoantibodies are a biomarker for more severe SLE renal disease requiring transplantation. Lupus (2007) 16, 394—400.

Key Words: autoantibodies • nephritis • renal transplant • systemic lupus erythematosus


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