RESEARCH - Autoantibodies against C-reative protein: clinical associations with SLE and primary APS

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Journal of Rheumatology

October 2006

Autoantibodies Against C-Reactive Protein: Clinical Associations in Systemic

Lupus Erythematosus and Primary Antiphospholipid Syndrome

MARIA A. FIGUEREDO, ANTONIA RODRIGUEZ, MARGARITA RUIZ-YAGÜE, MARTA ROMERO,

ARTURO FERNANDEZ-CRUZ, EMILIO GOMEZ-de la CONCHA, and RAMON PATIÑO

ABSTRACT.

Objective. To investigate the prevalence of anti-C-reactive protein (CRP)

autoantibodies in patients with systemic lupus erythematosus (SLE) and

non-SLE patients with persistent antiphospholipid antibodies (aPL) and their

association with clinical manifestations.

Methods. Sera of 137 patients with SLE, 127 with persistent aPL and 30 with

idiopathic venous thromboembolic disease, were assayed for the presence of

anti-CRP reactivity by ELISA. Associations of anti-CRP reactivity with

clinical features, with other autoantibodies, and with serum concentrations

of C3 and CRP were assessed.

Results. Antibodies against CRP were seen in 51% (n = 137) of patients with

SLE and in 54% (n = 127) of patients with aPL. SLE patients with anti-CRP

antibodies showed increased frequencies of anti-dsDNA and aPL antibodies

compared to those without anti-CRP (52% vs 26% and 68% vs 31%,

respectively). Mean serum C3 levels were lower in the subgroup of patients

with SLE positive for anti-CRP antibodies (79 ± 25 vs 92 ± 25 mg/dl; p =

0.004 ) and mean serum CRP levels were significantly higher (13 ± 17 vs 5 ±

8 mg/l; p = 0.01 ). The frequency of nephritis was higher in SLE patients

with anti-CRP antibodies, than in those without (27% vs 13%; p = 0.058). In

patients with clinical and serological evidence of antiphospholipid syndrome

(APS) the frequency of anti-CRP antibodies was significantly higher than in

asymptomatic aPL carriers, in both SLE patients [85% (23 of 27) vs 59% (19

of 32); p = 0.021] and non-SLE patients [76% (38 of 50) vs 19% (9 of 47); p

< 0.001]. Among patients with APS with or without SLE, 26 had arterial

events, 31 had venous events, 6 had combined arterial and venous events, and

14 had fetal loss. Mean titers of IgG anti-CRP (29 ± 21, 30 ± 19, 60 ± 37,

and 26 ± 12 AU/ml) and frequencies of anti-CRP antibodies (88%, 71%, 50%,

and 71%) in these subgroups of patients were comparable.

Conclusion. We confirmed the high prevalence of anti-CRP autoantibodies both

in patients with SLE and in non-SLE and aPL-positive patients. We observed

that the presence of these antibodies was associated with lupus nephritis

and with clinical features of the APS in patients with lupus and non-lupus

patients. (J Rheumatol 2006;33:1980-6)

http://www.jrheum.com/abstracts/abstracts06/1980.html

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