TY - JOUR
T1 - Urinary loss of immunoglobulin G anti-F(ab')2 and anti-DNA antibody in systemic lupus erythematosus nephritis
AU - Williams, Ralph C.
AU - Malone, Christine C.
AU - Miller, R. Tyler
AU - Silvestris, Francesco
N1 - Funding Information:
From the Division of Rheumatologya nd C1LnicalI mmunologya nd the Division of Nephrology,D epartmento f Medicine, Universityo f Florida; and the Department of Clinical Immunologya nd Oncology,U niversityo f Bari. Supported in part by Grants RO1AR40438 and AR13824-21A2 from the National Institutes of Health, by the Florida Chapter of the Arthritis Foundation, and by the Marcia Whitney Schott Endowment to the University of Florida for Research in Rheumatic Disease.
PY - 1998/9
Y1 - 1998/9
N2 - The objective of this study was to determine whether the low levels of serum immunoglobulin G (IgG) anti-F(ab')2 seen in some patients with active systemic lupus erythematosus (SLE) were directly related to the deposition of antibody with this specificity in the kidney or alternatively to the urinary loss of IgG anti-F(ab')2. Serum Levels of IgG anti-F(ab')2, anti-tetanus toxoid, and anti-ds DNA antibody were measured in parallel with urinary excretion of these same 3 antibodies in 28 patients with SLE nephritis and in 28 control patients with other forms of chronic kidney disease. Low levels of both serum IgG anti-F(ab')2 or anti-tetanus antibody appeared to correlate with increased levels of urinary loss of these same antibodies in some patients with SLE and in control subjects with kidney disease. However, urinary loss could not account for low serum levels of either IgG antibody in many subjects. Quantitative 24-hour urinary losses of IgG anti-F(ab')2 and anti-DNA were much higher in patients with SLE than in control subjects with kidney disease (P < .05), whereas amounts of IgG urinary loss of anti-tetanus were similar in patients with SLE and in control subjects. In nearly 1 third of SLE nephritis patients, 13% to 53% of total excreted urinary IgG showed anti-DNA enzyme-linked-immunosorbent assay reactivity. Urinary IgG in many patients with SLE showed both anti-DNA and anti-F(ab')2 reactivity, but dual anti-DNA/F(ab')2 specificity was more pronounced in affinity-isolated serum IgG anti-DNA or anti-F(ab')2 than in excreted urinary IgG molecules. The affinity of urinary IgG for either DNA or F(ab')2 was much lower than the same antibody activities measured either in serum or in kidney biopsy eluates. When the relative affinity of anti-DNA antibody in serum, urine, and kidney biopsy eluate was measured in parallel, the highest affinity antibody was found in kidney biopsy eluates, followed by serum antibody with urine antibody affinity showing the lowest values. These findings suggest a relative concentration of the highest affinity, doubly reactive IgG anti-DNA/F(ab')2 in SLE kidney tissues during SLE nephritis and implicate this process as an important factor in ongoing tissue damage.
AB - The objective of this study was to determine whether the low levels of serum immunoglobulin G (IgG) anti-F(ab')2 seen in some patients with active systemic lupus erythematosus (SLE) were directly related to the deposition of antibody with this specificity in the kidney or alternatively to the urinary loss of IgG anti-F(ab')2. Serum Levels of IgG anti-F(ab')2, anti-tetanus toxoid, and anti-ds DNA antibody were measured in parallel with urinary excretion of these same 3 antibodies in 28 patients with SLE nephritis and in 28 control patients with other forms of chronic kidney disease. Low levels of both serum IgG anti-F(ab')2 or anti-tetanus antibody appeared to correlate with increased levels of urinary loss of these same antibodies in some patients with SLE and in control subjects with kidney disease. However, urinary loss could not account for low serum levels of either IgG antibody in many subjects. Quantitative 24-hour urinary losses of IgG anti-F(ab')2 and anti-DNA were much higher in patients with SLE than in control subjects with kidney disease (P < .05), whereas amounts of IgG urinary loss of anti-tetanus were similar in patients with SLE and in control subjects. In nearly 1 third of SLE nephritis patients, 13% to 53% of total excreted urinary IgG showed anti-DNA enzyme-linked-immunosorbent assay reactivity. Urinary IgG in many patients with SLE showed both anti-DNA and anti-F(ab')2 reactivity, but dual anti-DNA/F(ab')2 specificity was more pronounced in affinity-isolated serum IgG anti-DNA or anti-F(ab')2 than in excreted urinary IgG molecules. The affinity of urinary IgG for either DNA or F(ab')2 was much lower than the same antibody activities measured either in serum or in kidney biopsy eluates. When the relative affinity of anti-DNA antibody in serum, urine, and kidney biopsy eluate was measured in parallel, the highest affinity antibody was found in kidney biopsy eluates, followed by serum antibody with urine antibody affinity showing the lowest values. These findings suggest a relative concentration of the highest affinity, doubly reactive IgG anti-DNA/F(ab')2 in SLE kidney tissues during SLE nephritis and implicate this process as an important factor in ongoing tissue damage.
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U2 - 10.1016/s0022-2143(98)90170-6
DO - 10.1016/s0022-2143(98)90170-6
M3 - Article
C2 - 9735927
AN - SCOPUS:13144254194
SN - 0022-2143
VL - 132
SP - 210
EP - 222
JO - Journal of Laboratory and Clinical Medicine
JF - Journal of Laboratory and Clinical Medicine
IS - 3
ER -