Lupus & antiphospholipid syndrome
Plasma C4d levels correlate with treatment response and renal activity in proliferative lupus nephritis
Authors' conclusion
All complement markers were affected by immunosuppressive therapy and associated with response to therapy. Levels of C4d and C4d/C4 at follow-up biopsies showed a strong association with both clinical and histopathological response in PLN. The correlation with elevated C4d and C4d/C4 and persisting high activity index on repeated biopsies strengthens the findings on C4d as a promising biomarker for treatment response in PLN. The C4 genetic variations did not influence C4 levels or response to treatment.
Study context
- Population
- Patients with active lupus nephritis (LN) confirmed by kidney biopsy, with second biopsies after immunosuppressive treatment
- Participants
- 77 patients
- Exposure
- Complement factors before vs after immunosuppressive treatment; Proliferative LN (PLN) vs membranous LN (MLN)
- PLNn = 60
- MLNn = 17
- Outcome
- Complement factors (C3, C4, C4d, C4d/C4) and treatment response
- Follow-up
- Second biopsy after treatment
Methodological detailsrepeat kidney biopsies
- Repeat kidney biopsies
Main finding
As reported in the abstract
- C3 and C4 increased and C4d and C4d/C4 decreased after treatment, in treatment-responding PLN but not in MLN
- P < 0.0001
- Low C4d levels in PLN with histopathological response
- P = 0.008
Observational data: associations, not effects.
Further findings
C4 gene copy number variations (C4A, C4B)
- Not associated with clinical or histopathological response
Original publication
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