The complex nature of serum C3 and C4 as biomarkers of lupus renal flare

The complex nature of serum C3 and C4 as biomarkers of lupus renal flare,10.1177/0961203310371154,Lupus,D. Birmingham,F. Irshaid,H. N. Nagaraja,X. Zou

The complex nature of serum C3 and C4 as biomarkers of lupus renal flare   (Citations: 2)
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Journal: Lupus , vol. 19, no. 8, 2010
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    • ... Third, serum C3 levels were only measured at the time of renal biopsy. Thus, whether hypoC3 persisted throughout the disease course is unknown. Interestingly, there were five patients who had follow-up data for serum C3 levels with a median duration of 22 months. They had persistently decreased serum C3 levels and four of them reached the doubling of the baseline serum creatinine. Therefore, it would be helpful to monitor the level serially to further clarify the clinical implications of hypoC3 in IgAN. Fourth, serum C3 levels and mesangial C3 deposition were not associated with the development of ESRD. This finding is partly due to the fact that ESRD occurred in only 14 patients (4.2%) during the follow-up period, thus resulting in a lack of statistical power. In addition, overall decline rate of eGFR did not differ between patients with hypoC3 and patients with normal C3 levels. It should be noted that most patients with hypoC3 reached the endpoints within 4 years after the baseline evaluation. This can explain the faster decline in eGFR in these patients until 4 years. However, it is possible that small number of events did not have adequate statistical power to see the difference in eGFR decline. Fifth, the presence of other diseases exhibiting both hypoC3 and mesangial IgA deposition could not entirely be excluded. However, we conducted a thorough pathologic examination and excluded patients with conditions such as systemic lupus erythematosus and IgA-dominant acute post-infectious glomerulonephritis. Moreover, we confirmed that autoantibodies such as antinuclear antibody or anti-DNA antibody were negative in all patients with hypoC3. Sixth, intensity of immunofluorescence may not be correct because of different condition of immunofluorescent staining, storage time, or altered antigenicity of immune complex by environmental proteases. However, in our institute, immunofluorescence pictures were generally taken immediately after biopsy samples were processed. Furthermore, to quantify the immunofluorescence intensity, these pictures were converted to digital images and analyzed using ImageJ software. Seventh, serum C3 levels were mildly decreased in 66 patients with hypoC3, suggesting that the disease may not truly be a ‘flare-up’, which can be seen in severe lupus nephritis ...

    Seung Jun Kimet al. Decreased Circulating C3 Levels and Mesangial C3 Deposition Predict Re...

    • ..., and fluctuation of serum C3 is a commonly used clinical biomarker of SLE disease activity ...

    Jian Zhaoet al. Association of Genetic Variants in Complement Factor H and Factor H-Re...

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