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. 1988 Nov;47(11):913–917. doi: 10.1136/ard.47.11.913

Correlation of the activation of the fourth component of complement (C4) with disease activity in systemic lupus erythematosus.

G Senaldi 1, V A Makinde 1, D Vergani 1, D A Isenberg 1
PMCID: PMC1003632  PMID: 3264693

Abstract

Levels of C4d, a fragment of C4 generated during activation of the classical complement pathway, were measured in the plasma of 48 patients with systemic lupus erythematosus, 11 with inactive (group 1), 23 with mildly active (group 2), 14 with moderately/severely active disease (group 3), and 30 healthy subjects. Levels of C3d, C4, and C3 were also measured and the C4d/C4 and C3d/C3 ratios calculated. C4d levels correlated with the degree of disease activity, being higher in group 3 than in group 2, in group 2 than in group 1, and in group 1 than in controls. C4d/C4 gave a similar result. Activation indices of the common complement pathway, C3d and C3d/C3, also correlated with disease activity, but in a non-linear relationship, failing to discriminate between patient groups. C4 and C3 showed no correlation with disease activity. These results indicate that indices of C4 activation, C4d and C4d/C4, provide a laboratory measure of disease activity in lupus patients, for whom an objective assessment of the severity of the disease is not readily available.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adler M. K., Baumgarten A., Hecht B., Siegel N. J. Prognostic significance of DNA-binding capacity patterns in patients with lupus nephritis. Ann Rheum Dis. 1975 Oct;34(5):444–450. doi: 10.1136/ard.34.5.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Davies E. T., Nasaruddin B. A., Alhaq A., Senaldi G., Vergani D. Clinical application of new technique that measures C4d for assessment of activation of classical complement pathway. J Clin Pathol. 1988 Feb;41(2):143–147. doi: 10.1136/jcp.41.2.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Falk R. J., Dalmasso A. P., Kim Y., Lam S., Michael A. Radioimmunoassay of the attack complex of complement in serum from patients with systemic lupus erythematosus. N Engl J Med. 1985 Jun 20;312(25):1594–1599. doi: 10.1056/NEJM198506203122502. [DOI] [PubMed] [Google Scholar]
  4. Fielder A. H., Walport M. J., Batchelor J. R., Rynes R. I., Black C. M., Dodi I. A., Hughes G. R. Family study of the major histocompatibility complex in patients with systemic lupus erythematosus: importance of null alleles of C4A and C4B in determining disease susceptibility. Br Med J (Clin Res Ed) 1983 Feb 5;286(6363):425–428. doi: 10.1136/bmj.286.6363.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hecht B., Siegel N., Adler M., Kashgarian M., Hayslett J. P. Prognostic indices in lupus nephritis. Medicine (Baltimore) 1976 Mar;55(2):163–181. doi: 10.1097/00005792-197603000-00005. [DOI] [PubMed] [Google Scholar]
  6. Inman R. D., Fong J. K., Pussell B. A., Ryan P. J., Hughes G. R. The C1q binding assay in systemic lupus erythematosus: discordance with disease activity. Arthritis Rheum. 1980 Nov;23(11):1282–1286. doi: 10.1002/art.1780231109. [DOI] [PubMed] [Google Scholar]
  7. Isenberg D. A., Colaco C. B., Dudeney C., Todd-Pokropek A., Snaith M. L. The relationship of anti-DNA antibody idiotypes and anti-cardiolipin antibodies to disease activity in systemic lupus erythematosus. Medicine (Baltimore) 1986 Jan;65(1):46–55. doi: 10.1097/00005792-198601000-00003. [DOI] [PubMed] [Google Scholar]
  8. Isenberg D. A., Shoenfeld Y., Schwartz R. S. Multiple serologic reactions and their relationship to clinical activity in systemic lupus erythematosus. Arthritis Rheum. 1984 Feb;27(2):132–138. doi: 10.1002/art.1780270203. [DOI] [PubMed] [Google Scholar]
  9. Levinsky R. J., Cameron J. S., Soothill J. F. Serum immune complexes and disease activity in lupus nephritis. Lancet. 1977 Mar 12;1(8011):564–567. doi: 10.1016/s0140-6736(77)91998-5. [DOI] [PubMed] [Google Scholar]
  10. Lloyd W., Schur P. H. Immune complexes, complement, and anti-DNA in exacerbations of systemic lupus erythematosus (SLE). Medicine (Baltimore) 1981 May;60(3):208–217. doi: 10.1097/00005792-198105000-00004. [DOI] [PubMed] [Google Scholar]
  11. Ludivico C. L., Zweiman B., Myers A. R., Hebert J., Green P. A. Predictive value of anti-DNA antibody and selected laboratory studies in systemic lupus erythematosus. J Rheumatol. 1980 Nov-Dec;7(6):843–849. [PubMed] [Google Scholar]
  12. Medicus R. G., Melamed J., Arnaout M. A. Role of human factor I and C3b receptor in the cleavage of surface-bound C3bi molecules. Eur J Immunol. 1983 Jun;13(6):465–470. doi: 10.1002/eji.1830130607. [DOI] [PubMed] [Google Scholar]
  13. Milgrom H., Curd J. G., Kaplan R. A., Müller-Eberhard H. J., Vaughan J. H. Activation of the fourth component of complement (C4): assessment by rocket immunoelectrophoresis and correlation with the metabolism of C4. J Immunol. 1980 Jun;124(6):2780–2785. [PubMed] [Google Scholar]
  14. Morrow W. J., Isenberg D. A., Parry H. F., Snaith M. L. C-reactive protein in sera from patients with systemic lupus erythematosus. J Rheumatol. 1981 Jul-Aug;8(4):599–604. [PubMed] [Google Scholar]
  15. Morrow W. J., Isenberg D. A., Todd-Pokropek A., Parry H. F., Snaith M. L. Useful laboratory measurements in the management of systemic lupus erythematosus. Q J Med. 1982 Spring;51(202):125–138. [PubMed] [Google Scholar]
  16. Morrow W. J., Williams D. J., Ferec C., Casburn-Budd R., Isenberg D. A., Paice E., Snaith M. L., Youinou P., Le Goff P. The use of C3d as a means of monitoring clinical activity in systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis. 1983 Dec;42(6):668–671. doi: 10.1136/ard.42.6.668. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schur P. H. Complement and lupus erythematosus. Arthritis Rheum. 1982 Jul;25(7):793–798. doi: 10.1002/art.1780250715. [DOI] [PubMed] [Google Scholar]
  18. Schutte M., DiCamelli R., Murphy P., Sadove M., Gewurz H. Effects of anesthesia, surgery and inflammation upon host defense mechanisms. I. Effects upon the complement system. Int Arch Allergy Appl Immunol. 1975;48(5):706–720. doi: 10.1159/000231358. [DOI] [PubMed] [Google Scholar]
  19. Swaak A. J., van Rooyen A., Vogelaar C., Pillay M., Hack E. Complement (C3) metabolism in systemic lupus erythematosus in relation to the disease course. Rheumatol Int. 1986;6(5):221–226. doi: 10.1007/BF00541371. [DOI] [PubMed] [Google Scholar]
  20. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  21. Valentijn R. M., van Overhagen H., Hazevoet H. M., Hermans J., Cats A., Daha M. R., van ES L. A. The value of complement and immune complex determinations in monitoring disease activity in patients with systemic lupus erythematosus. Arthritis Rheum. 1985 Aug;28(8):904–913. doi: 10.1002/art.1780280810. [DOI] [PubMed] [Google Scholar]
  22. Vergani D., Bevis L., Nasaruddin B. A., Mieli-Vergani G., Tee D. E. Clinical application of a new nephelometric technique to measure complement activation. J Clin Pathol. 1983 Jul;36(7):793–797. doi: 10.1136/jcp.36.7.793. [DOI] [PMC free article] [PubMed] [Google Scholar]

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