Absence of anti-glomerular basement membrane antibodies in 200 patients with systemic lupus erythematosus with or without lupus nephritis: results of the GOODLUPUS study
Introduction Anti-glomerular basement membrane (GBM) antibodies are pathogenic antibodies first detected in renal-limited anti-GBM disease and in Goodpasture disease, the latter characterized by rapidly progressive crescentic glomerulonephritis combined with intra-alveolar hemorrhage. Studies have s...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
14 December 2020
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| In: |
Frontiers in immunology
Year: 2020, Volume: 11, Pages: 1-9 |
| ISSN: | 1664-3224 |
| DOI: | 10.3389/fimmu.2020.597863 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fimmu.2020.597863 Verlag, lizenzpflichtig, Volltext: https://www.frontiersin.org/article/10.3389/fimmu.2020.597863 
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| Author Notes: | Nellie Bourse Chalvon, Pauline Orquevaux, Delphine Giusti, Gregory Gatouillat, Thierry Tabary, Marcelle Tonye Libyh, Jan Chrusciel, Moustapha Drame, Grace Stockton-Bliard, Zahir Amoura, Laurent Arnaud, Hanns-Martin Lorenz, Gilles Blaison, Bernard Bonnotte, Nadine Magy-Bertrand, Sabine Revuz, Reinhard Edmund Voll, Oliver Hinschberger, Andreas Schwarting, Bach Nga Pham, Thierry Martin, Jean-Loup Pennaforte and Amelie Servettaz |
| Summary: | Introduction Anti-glomerular basement membrane (GBM) antibodies are pathogenic antibodies first detected in renal-limited anti-GBM disease and in Goodpasture disease, the latter characterized by rapidly progressive crescentic glomerulonephritis combined with intra-alveolar hemorrhage. Studies have suggested that anti-GBM antibody positivity may be of interest in lupus nephritis (LN). Moreover, severe anti-GBM vasculitis cases in patients with systemic lupus erythematosus (SLE) have been described in the literature, but few studies have assessed the incidence of anti-GBM antibodies in SLE patients.ObjectiveThe main study objective was to determine if positive anti-GBM antibodies were present in the serum of SLE patients with or without proliferative renal damage and compared to a healthy control group.MethodologyThis retrospective study was performed on SLE patients’ sera from a Franco-German European biobank, developed between 2011 and 2014, from 17 hospital centers in the Haut-Rhin region. Patients were selected according to their renal involvement, and matched by age and gender. The serum from healthy voluntary blood donors was also tested. Anti-GBM were screened by fluorescence enzyme immunoassay (FEIA), and then by indirect immunofluorescence (IIF) in case of low reactivity detection (titer >6 U/ml).ResultsThe cohort was composed of 100 SLE patients with proliferative LN (27% with class III, 67% with class IV, and 6% with class V), compared to 100 SLE patients without LN and 100 controls. Patients were mostly Caucasian and met the ACR 1997 criteria and/or the SLICC 2012 criteria. Among the 300 tested sera, no significant levels of anti-GBM antibodies were detected (>10 U/ml) by the automated technique, three sera were found “ambivalent” (>7 U/ml): one in the SLE with LN group and two in the SLE without LN group. Subsequent IIF assays did not detect anti-GBM antibodies.ConclusionAnti-GBM antibodies were not detected in the serum of Caucasian patients with SLE, even in case of renal involvement, a situation favoring the antigenic exposure of glomerular basement membranes. Our results reaffirm the central role of anti-GBM antibodies as a specific diagnostic biomarker for Goodpasture vasculitis and therefore confirm that anti-GBM antibody must not be carried out in patients with SLE (with or without LN) in the absence of disease-suggestive symptoms. |
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| Item Description: | Gesehen am 03.03.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1664-3224 |
| DOI: | 10.3389/fimmu.2020.597863 |