Cell-bound complement activation products (CB-CAPs) have high sensitivity and specificity in pediatric-onset systemic lupus erythematosus and correlate with disease activity

Autor:	M Ma, Tyler O'Malley, John Conklin, Yevgeniya Gartshteyn, Joyce S Hui-Yuen, L F Imundo, A H Eichenfield, Anca D. Askanase, Thierry Dervieux
Rok vydání:	2018
Předmět:	0301 basic medicine Male Adolescent Pediatric onset Cell Sensitivity and Specificity Severity of Illness Index Disease activity 03 medical and health sciences Young Adult 0302 clinical medicine Rheumatology medicine Humans Lupus Erythematosus Systemic Prospective Studies Age of Onset Complement Activation Autoantibodies 030203 arthritis & rheumatology Immunoassay Systemic lupus erythematosus business.industry Complement System Proteins medicine.disease Flow Cytometry Complement system 030104 developmental biology medicine.anatomical_structure Immunology Female business Biomarkers
Zdroj:	Lupus. 27(14)
ISSN:	1477-0962
Popis:	Objective Elevated levels of cell-bound complement activation products (CB-CAPs) (C4d deposition on B lymphocytes (BC4d) and/or erythrocytes (EC4d)) are sensitive and specific in diagnosis and monitoring of adult systemic lupus erythematosus (SLE). Our objective was to evaluate the role of CB-CAPs for diagnosis and monitoring of pediatric-onset SLE (pSLE). Methods A prospective cohort study of 28 pSLE and 22 juvenile arthritis patients was conducted. SLE disease activity was determined using a clinical Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) that excluded serologies. Autoantibodies were measured using solid-phase immunoassays, C3 and C4 using immunoturbidimetry, and CB-CAPs using quantitative flow cytometry. Abnormal CB-CAPs were defined as EC4d or BC4d above the 99th percentile for healthy adults (>14 and > 60 net mean fluorescence intensity (MFI), respectively). Performance characteristics of CB-CAPs were assessed using area under the curve (AUC) for receiver operating characteristics. Linear mixed effect models evaluated the correlation between CB-CAPs and clinical SLEDAI over 6 months. Results BC4d yielded higher AUC (0.91 ± 0.04) than C3 (0.63 ± 0.08) and C4 (0.67 ± 0.08) ( p Conclusion CB-CAPs (EC4d and BC4d) have higher sensitivity and specificity than low complement in pSLE, and may help with diagnosis of pSLE. EC4d could provide a useful biomarker for disease activity monitoring.
Databáze:	OpenAIRE
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