Clinical importance of autoantibodies in lupus nephritis

Abstract

Renal involvement is a serious clinical feature of systemic lupus erythematosus and can present at any stage of the disease. Although its treatment and outcome have improved, lupus nephritis is still a major contributor to morbidity. Autoantibodies, particularly those directed toward nuclear antigens, are a major feature of systemic lupus erythematosus. With respect to nephritis, there are several aspects of lupus autoantibodies that merit attention, including their use in diagnosis and monitoring, and their role in pathogenesis. Anti-dsDNA antibodies are well known, but other important autoantibodies include anti-C1q, antinucleosomal and antiactinin. There has also been interesting work on the relationship of antiphospholipid antibodies with renal disease.

Keywords::

• actinin
• anti-C1q
• anti-dsDNA
• antiphospholipid
• nucleosome

Financial & competing interests disclosure

MY Karim has received an unrestricted grant from Aspreva Pharmaceuticals to help establish a research clinic in lupus nephritis at the Lupus Unit, St Thomas' Hospital, London, UK. DP D'Cruz reports receiving unrestricted research grant support from Aspreva Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

*Indicates the proportion of glomeruli with active and with sclerotic lesions.

^‡Indicates the proportion of glomeruli with fibrinoid necrosis and with cellular crescents.

^§Class V may occur in combination with class III or IV in which case both will be diagnosed.

Indicate and grade (mild, moderate, severe) tubular atrophy, interstitial inflammation and fibrosis, severity of arteriosclerosis or other vascular lesions. ISN: International Society of Nephrology; RPS: Renal Pathology Society.

Adapted from [5].