Correlation of some Immunological Markers with Systemic Lupus Erythematosus disease
DOI:
https://doi.org/10.36320/ajb/v12.i1.8141Abstract
SLE (Systemic Lupus Erythematosus) is, a heterogeneous disease, with ,diverse clinical manifestation disorder characterized by hyperactivity of B and T cell, creation of auto, antibodies, and, deposition, of antibody- containing immune complexes in blood vessels, during body. This study aims to investigation some immunological markers related to patients with SLE. It includes the study of the level, of Interleukin, (IL.17), antinuclear antibody (ANA), anti dsDNA, antiphospholipid and, complement, C3, C4, In addition to study the complete blood picture including hemoglobin, red blood cell monocytes, white blood cells, platelets and lymphocytes, they belong to factors that may interfere with the disease. Current study included 110 patients with SLE, and 106 (96.36%) were female and 4 (3.64%) were male. Patients with an average age of 31.61 ± 8.60 years. This work also includes 70 blood specimens as control group. Our study illustrated that most infections were on Village 71.82 % compared with the City 28.18 , and patients without history disease 57.27 % while patients with history disease42.73%. The results also showed that the concentration of IL.17 was significantly higher than p ≤ 0.05 in serum patients with lupus erythematosus (469 ± 2.25 g / ml) comparison with healthy individuals (107.39 ± 0.41 pg / ml). ELISA was used to measure some types of autoantibodies, and showed an increase in ANA and dsDNA Ab levels in SLE patients compared with healthy individuals. The results also prone that the antiphospholipid is significantly increase (P ≤ 0.05) in patients with SLE compared to controls.Evaluating serum complement level C3, C4 in the total study, our results observed significant decrease (p ≤ 0.05) in serum of patients with SLE (0.62 ± 0.01,0.13 ± 0.01g/l) respectively, compared with controls ,(1.74 ± 0.01,0.28 ± 0.01g/l) respectively.The results of the study also showed a significant decrease in hemoglobin, red blood cell monocytes, white blood cells, platelets and the number of lymphocytes for SLE patients compared with healthy individuals.The relationship between antibodies to ANA and IL-17, antibodies to dsDNA and C3, C4 and lymphocytes was identified, as well as the relationship between APA, C3 and C4 antibodies. Inconclusion ,peoples with SLE have a positive ANA, High concentration of, ds DNA Ab and anti-phospholipid which plays an important role in pathogenesis and complement C3 and C4 in patients with SLE is decreased. An increased inflammatory concentration of interleukin (IL.17) can play a critical role in the pathogenesis of SLE which leads to disease progression.
Downloads
References
Stojan G.,Petri M. Epidemiology of systemic lupus erythematosus: An update. Curr Opin Rheumatol. 2018;30(2):144-50. DOI: https://doi.org/10.1097/BOR.0000000000000480
Pan, L., Lu, M.-P., Wang, J.-H., Xu, M., & Yang, S.-R.. Immunological pathogenesis and treatment of systemic lupus erythematosus. World Journal of Pediatrics. 2019; doi:10.1007/s12519-019-00229-3 DOI: https://doi.org/10.1007/s12519-019-00229-3
Manuel Rojas, Yhojan Rodríguez, Kelly Joan Leon, Yovana Pacheco, Yeny Acosta- Ampudia, Diana M. Monsalve, Carolina Ramírez-Santana, Juan-Manuel Anaya. Cytokines and Inflammatory Mediators in Systemic Lupus Erythematosus . EMJ Rheumatol. 2018 ;5[1]:83-92. DOI: https://doi.org/10.33590/emjrheumatol/10311457
Lande, R., Ganguly, D., Facchinetti, V., Frasca, L., Conrad, C., Gregorio, J., … Gilliet, M. Neutrophils Activate Plasmacytoid Dendritic Cells by Releasing Self-DNA-Peptide Complexes in Systemic Lupus Erythematosus. Science Translational Medicine, 2011; 3(73), 73ra19. doi:10.1126/scitranslmed.3001180 DOI: https://doi.org/10.1126/scitranslmed.3001180
Tipton CM, Fucile CF, Darce J, et al. Diversity, cellular origin and autoreactivity of antibody-secreting cell population expansions in acute systemic lupus erythematosus. Nat Immunol.2015;16:755‐765. DOI: https://doi.org/10.1038/ni.3175
Halliley JL, Tipton CM, Liesveld J, et al. Long-lived plasma cells are contained within the CD19(-) CD38(hi)CD138(+) subset in human bone marrow. Immunity. 2015;43:132‐145. DOI: https://doi.org/10.1016/j.immuni.2015.06.016
Crispin JC, Liossis SN, Kis-Toth K, Lieberman LA, Kyttaris VC, Juang YT, et al. Pathogenesis of human systemic lupus erythematosus: recent advances. Trends Mol Med. 2010;16(2):47-57. doi: 10.1016/j.molmed.2009.12.005. DOI: https://doi.org/10.1016/j.molmed.2009.12.005
Ohl, K., & Tenbrock, K. Inflammatory Cytokines in Systemic Lupus Erythematosus. Journal of Biomedicine and Biotechnology, 2011; 1–14. doi:10.1155/2011/432595. DOI: https://doi.org/10.1155/2011/432595
Santos, F. M. M., Telles, R. W., Lanna, C. C. D., Teixeira, A. L., Miranda, A. S., Rocha, N. P., & Ribeiro, A. L.. Adipokines, tumor necrosis factor and its receptors in female patients with systemic lupus erythematosus. Lupus. 2016 ; 26(1), 16. doi:10.1177/0961203316646463.
Ricklin D, Hajishengallis G, Yang K, et al. Complement: a key system for immune surveillance and homeostasis. Nat Immunol 2010;11:785–97. DOI: https://doi.org/10.1038/ni.1923
Leffler, J., Bengtsson, A. A., & Blom, A. M. The complement system in systemic lupus erythematosus: an update. Annals of the Rheumatic Diseases, 2014; 73(9), 1601–1606. doi:10.1136/annrheumdis-2014-205287. DOI: https://doi.org/10.1136/annrheumdis-2014-205287
Jordan N. Management of pregnancy in systemic lupus erythematosus: What a GP should know. Lupus. 2018;27:40-43. DOI: https://doi.org/10.1177/0961203318801746
Rees F, Doherty M, Grainge MJ, et al. The worldwide incidence and prevalence ofsystemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology; 2017; 56: 1945-1961. DOI: https://doi.org/10.1093/rheumatology/kex260
Chen Z, Zhang H, Xia B, Wang P, Jiang T, Song M, et al. Association of PTPN22 gene(rs2488457) polymorphism with ulcerative colitis and high levels of PTPN22 mRNA in ulcerative colitis. Int J Colorectal Dis. 2013;28(10):1351-8. doi: 10.1007/s00384-013- 1671-3. DOI: https://doi.org/10.1007/s00384-013-1671-3
Gregersen PK, Olsson LM. Recent advances in the genetics of autoimmune disease. Annu Rev Immunol. 2009;27:363-91. DOI: https://doi.org/10.1146/annurev.immunol.021908.132653
Zhu H, Luo H, Yan M, Zuo X, Li QZ. Autoantigen Microarray for High-throughput Autoantibody Profiling in Systemic Lupus Erythematosus. Genomics Proteomics Bioinformatics. 2015;13(4):210-8. doi: 10.1016/j.gpb.2015.09.001. DOI: https://doi.org/10.1016/j.gpb.2015.09.001
Tan, E. M., Cohen, A. S., Fries, J. F., Masi, A. T., Mcshane, D. J., Rothfield, N. F., Winchester, R. J. The revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism, 1982;25(11), 1271–1277. doi:10.1002/art.1780251101 DOI: https://doi.org/10.1002/art.1780251101
Postal, M., Lapa, A. T., Sinicato, N. A., de Oliveira Peliçari, K., Peres, F. A., Costallat, L. T. L., Appenzeller, S.. Depressive symptoms are associated with tumor necrosis factor alpha in systemic lupus erythematosus. Journal of Neuroinflammation, 2016; 13(1). doi:10.1186/s12974-015-0471-9 DOI: https://doi.org/10.1186/s12974-015-0471-9
Rosenblat JD, Cha DS, Mansur RB, McIntyre RS. Inflamed moods: a review of the interactions between inflammation and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2014;53:23–34. DOI: https://doi.org/10.1016/j.pnpbp.2014.01.013
Choi, M. Y., Clarke, A. E., St.Pierre, Y., Hanly, J. G., Urowitz, M. B., Romero-Diaz, J., Fritzler, M. J. Antinuclear Antibody-Negative Systemic Lupus Erythematosus in an International Inception Cohort. Arthritis Care & Research. 2018; doi:10.1002/acr.23712 DOI: https://doi.org/10.1002/acr.23712
Joseph Sushil Rao1, Vineeta Shobha2, Tinku Thomas3, Usha Kini. Standardizing initial dilution titers of antinuclear antibodies for the screening of systemic lupus erythematosus Phys.Rev. 2019; 47,777-780.
Leuchten, N., Hoyer, A., Brinks, R., Schoels, M., Schneider, M., Smolen, J. Performance of Antinuclear Antibodies for Classifying Systemic Lupus Erythematosus: A Systematic Literature Review and Meta-Regression of Diagnostic Data. Arthritis Care & Research, 2018; 70(3), 428–438. doi:10.1002/acr.23292. DOI: https://doi.org/10.1002/acr.23292
Tarazi, M., Gaffney, R. G., Kushner, C. J., Chakka, S., & Werth, V. P. Cutaneous lupus erythematosus patients with a negative antinuclear antibody meeting the American College of Rheumatology and/or Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus. Arthritis Care & Research. 2019; doi:10.1002/acr.23916 DOI: https://doi.org/10.1002/acr.23916
Cross LS, Aslam A, Misbah SA. Antinuclear antibody-negative lupus as a distinct diagnostic entity – Does it no longer exist? QJM. 2004;97:303-8. DOI: https://doi.org/10.1093/qjmed/hch048
Schmajuk G, Hoyer BF, Aringer M, Johnson SR, Daikh DI, Dörner T. Multi-center Delphi Exercise Reveals Important Key Items for Classifying Systemic Lupus Erythematosus. Arthritis Care & Research .2017; doi:10.1002/acr.23503. DOI: https://doi.org/10.1002/acr.23503
Ghosh P, Dwivedi S, Naik S, Agarwal V, Verma A, Aggarwal A, et al. Antinuclear antibodies by indirect immunofluorescence: Optimum screening dilution for diagnosis of systemic lupus erythematosus. Indian J Med Res. 2007;126:34-8.
Au EY. ANA testing: What should we know about the methods, indication and interpretation? Hong Kong Bull Rheumatic Dis. 2017;2:53-7. DOI: https://doi.org/10.1515/hkbrd-2017-0007
Hahn, B. H.Antibodies to DNA.‖ The New England Journal of Medicine., 1998; 338(19):1359–1368. DOI: https://doi.org/10.1056/NEJM199805073381906
Javier Narváez,Helena Borrell,Fernando Sánchez-Alonso,Iñigo Rúa-gueroa,Francisco Javier López-Longo,María Galindo-Izquierdo,Jaime Calvo Alén,Antonio FernándeznNebro,Alejandro Olivé, José Luis Andreu,Víctor Martínez- Taboada,Joan Miquel Nolla, José María Pego-Reigosa . Primary respiratory disease in patients with systemic lupus erythematosus: data from the Spanish rheumatology society lupus registry . Arthritis Research & Therapy.2018;20:280. DOI: https://doi.org/10.1186/s13075-018-1776-8
Barnado, A., Carroll, R. J., Casey, C., Wheless, L., Denny, J. C., & Crofford, L. J. Phenome-wide association study identifies dsDNA as a driver of major organ involvement in systemic lupus erythematosus. Lupus, 2018; 096120331881557. doi:10.1177/0961203318815577 DOI: https://doi.org/10.1177/0961203318815577
Mosca, M., Costenbader, K. H., Johnson, S. R., Lorenzoni, V., Sebastiani, G. D., Hoyer, B. F. How Do Patients with Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria. Arthritis & Rheumatology. 2018; doi:10.1002/art.40674 DOI: https://doi.org/10.1002/art.40674
Ciccacci, C.; Perricone, C.and Ceccarelli, F. A multilocus genetic study in a cohort of Italian SLE patients confirms the association with STAT4 gene and describes a new association with HCP5 gene. PLoS ONE. 2014;9(11): Article ID e111991. DOI: https://doi.org/10.1371/journal.pone.0111991
Asherson ,R.A. and Cervera, R.Antiphospholipid syndrome. J Invest Dermatol., 1993; 100: 21-27. DOI: https://doi.org/10.1111/1523-1747.ep12355193
Petri, M. Epidemiology of the antiphospholipid antibody syndrome. J Autoimmun .,2000;15:145–51. DOI: https://doi.org/10.1006/jaut.2000.0409
Chighizola, C. B., & Meroni, P. L. Thrombosis and Anti-phospholipid Syndrome: a 5-Year Update on Treatment. Current Rheumatology Reports, 2018; 20(7). doi:10.1007/s11926-018-0741-5 DOI: https://doi.org/10.1007/s11926-018-0741-5
Pons-Estel, G. J., Andreoli, L., Scanzi, F., Cervera, R., & Tincani, A. The antiphospholipid syndrome in patients with systemic lupus erythematosus. Journal of Autoimmunity, 2017; 76, 10–20. doi:10.1016/j.jaut.2016.10.004 DOI: https://doi.org/10.1016/j.jaut.2016.10.004
Urowitz M.B, D. Ibanez, J. Su, D.D. Gladman, Modified framingham risk factor score for systemic lupus erythematosus, J. Rheumatol. 2016; 43. 875e879. DOI: https://doi.org/10.3899/jrheum.150983
Takeno, M.; Nagafuchi, H.; Kaneko, S.; Wakisaka, S.; Oneda, K.; Takeba, Y.; Yamashita, N.; Suzuki, N.; Kaneoka, H. and Sakane, T. Autoreactive T cell clones from patients with systemic lupus erythematosus support polyclonal autoantibody production. J Immunol ., 1997;158(7):3529-3538. DOI: https://doi.org/10.4049/jimmunol.158.7.3529
Mok, M.Y.; Leung, P.Y. and Lao, T.H. Clinical predictors of fetal and maternal outcome in Chinese patients with systemic lupus erythematosus. Ann Rheum Dis. 2004;63:1705–6. DOI: https://doi.org/10.1136/ard.2004.022442
Pierangeli, S.S. and Harris, E.N. A quarter of a century in anticardiolipin antibody testing and attempted standardization has led us to here, which is? Semin Thromb Hemost. 2008 ;34(4):313–28. DOI: https://doi.org/10.1055/s-0028-1085473
Elewa ,E. A. ;Zakaria, O.;Mohamed ,E.I. and Boghdadi .G. The role of interleukins 4, 17 and interferon gamma as biomarkers in patients with Systemic Lupus Erythematosus and their correlation with disease activity. The Egyptian Rheumatologist . 2014;36: 21–27. DOI: https://doi.org/10.1016/j.ejr.2013.10.003
Yamei Tang, Huai Tao, Yuji Gong, Fang Chen, Cunyan Li, and Xiudeng Yang. Changes of Serum IL-6, IL-17, and Complements in Systemic Lupus Erythematosus Patients Journal of Interferon & Cytokine Research. 2019; 10.1089. jir. 0169
Tanaka A , T Ito, K Kibata. Serum high-mobility group box 1 is correlated with interferon-α and may predict disease activity in patients with systemic lupus erythematosus. Sage Journals. 2019; ISSN: 0961-2033 DOI: https://doi.org/10.1177/0961203319862865
Umare, V., Pradhan, V., Nadkar, M., Rajadhyaksha, A., Patwardhan, M., Ghosh, K. K., & Nadkarni, A. H. Effect of Proinflammatory Cytokines (IL-6, TNF-α, and IL-1β) on Clinical Manifestations in Indian SLE Patients. Mediators of Inflammation, 2014; 1–8. doi:10.1155/2014/385297 DOI: https://doi.org/10.1155/2014/385297
Hammad A, Osman E, Mosaad Y, Wahba M. Serum interleukin-17 in Egyptian children with systemic lupus erythematosus: is it related to pulmonary affection? Lupus.2017; 26(4):388–395. DOI: https://doi.org/10.1177/0961203316665709
Pan Q, Gong L, Xiao H, Feng Y, Li L, Deng Z, Ye L, Zheng J,Dickerson CA, Ye L, An N, Yang C, Liu HF. Basophil activation-dependent autoantibody and interleukin-17 production exacerbate systemic lupus erythematosus. Front Immunol2017; 8:348. DOI: https://doi.org/10.3389/fimmu.2017.00348
Wu Y, Cai B, Zhang J, Shen B, Huang Z, Tan C, Baan CC, Wang L. IL-1beta and IL-6 are highly expressed in RF+IgE+ systemic lupus erythematous subtype. J Immunol Res.2017;:5096741. DOI: https://doi.org/10.1136/lupus-2017-000215.331
Abdel Galil SM, Ezzeldin N, El-Boshy ME. The role of serum IL-17 and IL-6 as biomarkers of disease activity and predictors of remission in patients with lupus nephritis. Cytokine. 2015; 76(2):280–287. DOI: https://doi.org/10.1016/j.cyto.2015.05.007
Tang, Y., Tao, H., Gong, Y., Chen, F., Li, C., & Yang, X. Changes of Serum IL-6, IL-17, and Complements in Systemic Lupus Erythematosus Patients. Journal of Interferon & Cytokine Research. 2019;doi:10.1089/jir.2018.0169 DOI: https://doi.org/10.1089/jir.2018.0169
Idborg, H., Eketjäll, S., Pettersson, S., Gustafsson, J. T., Zickert, A., Kvarnström, M., Svenungsson, E. TNF-α and plasma albumin as biomarkers of disease activity in systemic lupus erythematosus. Lupus Science & Medicine, 2018;5(1), e000260. doi:10.1136 DOI: https://doi.org/10.1136/lupus-2018-000260
Aysha I.Z. Badawi a, Alaa M. Abd El-Hamid a, Noha Kh. Mohamed a, Enas M.M. Darwish a, Mona Wassef, Hala Elfirganica . Serum tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and leptin as biomarkers of accelerated atherosclerosis in patients with systemic lupus erythematosus and antiphospholipid syndrome. The Egyptian Rheumatologist . 2017; 39 (2),P:75-81. DOI: https://doi.org/10.1016/j.ejr.2016.07.001
Li H, Lin S, Yang S, Chen L, Zheng X. Diagnostic value of serum complement C3 and C4 levels in Chinese patients with systemic lupus erythematosus. Clin Rheumatol. 2015; 34(3):471–477. DOI: https://doi.org/10.1007/s10067-014-2843-4
Vaneet Sandhu , Michele Quan, SLE and Serum Complement: Causative, Concomitant or Coincidental?, The Open Rheumatology Journal, 2017; DOI: 10.2174/1874312901711010113, 11, 113-122 . DOI: https://doi.org/10.2174/1874312901711010113
Potlukova, E. and Kralikova, P. Complement component C1q and Anti-C1q Antibodies in Theory and in clinical P ractice. Scandinavian Journal of Immunology. 2008; 67(5): 423 – 430. DOI: https://doi.org/10.1111/j.1365-3083.2008.02089.x
Sabry,A.; Kalil,M. ; El-Rahim,M.; El-Shahat, F.; Elbasyouni,R. Proinflammatory Cytokines (TNF alpha and IL-6) in Egyptian SLE patients with Lupus Nephritis is it correlated with disease activity.Eur J Gen Med., 2005; 2(4):153-158. DOI: https://doi.org/10.29333/ejgm/82333
Lam, S.K and Quah, T.C. Anemia in systemic lupus erythematosus. J Singapore Paediatr Soc., 1990; 32(3-4):132-6.
Giannouli, S.; Voulgarelis, M.; Ziakas, P.D. and Tzioufas, A.G. Anaemia in systemic lupus erythematosus, from pathophysiology to clinical assessment. Ann Rheum Dis. 2006 ;65(2):144-8. DOI: https://doi.org/10.1136/ard.2005.041673
AL- Alfy,M .N.; AL- Hakim, M. S.; Abd Elmouttaleb, A .T.; Bayomy, E. M.; Abonar, A. A. and aAbood, M. A. Study of Interleukin-12 Cytokine and Anti-C1q Antibodies in Lupus Nephritis Patients. International Journal of Internal Medicine . 2014 ;3(1): 13-26.
Santos, F. M. M., Telles, R. W., Lanna, C. C. D., Teixeira, A. L., Miranda, A. S., Rocha, N. P., & Ribeiro, A. L. Adipokines, tumor necrosis factor and its receptors in female patients with system iclupus erythematosus. Lupus, 2016; 26(1), 10– 16. doi:10.1177/0961203316646463. DOI: https://doi.org/10.1177/0961203316646463
Kapouzas, G.A.Hematological and Lymphoid Abnomalities in SLE. In: Wallace, D.J and Hahn, B.H. DUBOIS’ Lupus erythmatosus and Related Syndomes. 8th edn. Philadelphia: Elsevier., 2013; 426–37. DOI: https://doi.org/10.1016/B978-1-4377-1893-5.00034-0
Chang-Hee Suh, Ju-Yang Jung,Dukyong Yoon, Hyoun-Ah Kim and Sang-Heon Lee . Serositis, hematologic involvement, and steroid dose are risk factors for serious infections in patients with systemic lupus erythematosus. 2019; 6 (1)
Koga, T., Ichinose, K., Kawakami, A., & Tsokos, G. C. The role of IL-17 in systemic lupus erythematosus and its potential as a therapeutic target. Expert Review of Clinical Immunology. 2019; doi:10.1080/1744666x.2019.1593141. DOI: https://doi.org/10.1080/1744666X.2019.1593141
Pacheco, Y., Barahona-Correa, J., Monsalve, D. M., Acosta-Ampudia, Y., Rojas, M., Rodriguez, Y.,. Anaya, J-M. Cytokine and autoantibody clusters interaction in systemic lupus erythematosus. Journal of Translational Medicine, 2017; 15. https://doi.org/10.1186/s12967-017-1345-y DOI: https://doi.org/10.1186/s12967-017-1345-y
López, P., de Paz, B., Rodríguez-Carrio, J., Hevia, A., Sánchez, B., Margolles, A., & Suárez, A. Th17 responses and natural IgM antibodies are related to gut microbiota composition in systemic lupus erythematosus patients. Scientific Reports, 2016; 6(1). doi:10.1038/srep24072. DOI: https://doi.org/10.1038/srep24072
Vila, L.M.; Alarcon, G.S.; Mcgwin, G. J.; Bastian, H.M.; Fessier, B.J. and Reveille, J.D.Systemic lupus erythematosus in a multiethnic US cohort, XXXVII,association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual .Arthritis Rheum. 2006; 55:799–806. DOI: https://doi.org/10.1002/art.22224
Shoenfeld, Y.; Zamir, R. a`12nd Joshua, H. Human monoclonal anti-DNA antibodies react as lymphocytotoxic antibodies. Eur J Immunol ., 1985; 15:1024-8. DOI: https://doi.org/10.1002/eji.1830151012
Nakabayashi, K.; Arimura, Y.; Yoshida, M. and Nagasawa, T. Anti-T cell antibodies in primary glomerulonephritis. Clin Nephrol., 1985;23: 74–80.
Bernstein, K.A.; Kahl, L.E.; Balow, J.E. and Lefkowith, J.B. Serologic markers of lupus nephritis in patients: use of a tissue based ELISA and evidence for immunopathogenetic heterogeneity. Clin Exp Immunol ., 1994;98:60–5. DOI: https://doi.org/10.1111/j.1365-2249.1994.tb06607.x
Linnik, M.D.; Hu, J.Z.; Heilbrunn, K.R.; Strand ,V.; Hurley, F.L. and Joh, T. Relationship between anti double-stranded DNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus. Arthr Rheum., 2005;52(4):1129–37. DOI: https://doi.org/10.1002/art.20980
Ng, K.P.; Manson, J.J.; Rahman, A. and Isenberg, D.A. Association of antinucleosome antibodies with disease flare in serologically active clinically quiescent patients with systemic lupus erythematosus. Arthr Care Res. 2006 ;55(6):900–4. DOI: https://doi.org/10.1002/art.22356
Garabet, L., Gilboe, I.-M., Mowinckel, M.-C., Jacobsen, A. F., Mollnes, T. E., Sandset, P. M., & Jacobsen, E.-M. Antiphospholipid Antibodies are Associated with Low Levels of Complement C3 and C4 in Patients with Systemic Lupus Erythematosus. Scandinavian Journal of Immunology, 2016; 84(2), 95–99. doi:10.1111/sji.12445. DOI: https://doi.org/10.1111/sji.12445
Fabrizio, C., Fulvia, C., Carlo, P., Laura, M., Elisa, M., Francesca, M., Guido,V. Systemic Lupus Erythematosus with and without Anti-dsDNA Antibodies: Analysis from a Large Monocentric Cohort. Mediators of Inflammation, 2015; 1–6. doi:10.1155/2015/328078. DOI: https://doi.org/10.1155/2015/328078
Giles BM, Boackle SA. Linking complement and anti-dsDNA antibodies in the pathogenesis of systemic lupus erythematosus. Immunol Res 2013;55:10–21 DOI: https://doi.org/10.1007/s12026-012-8345-z
Pierangeli SS, Girardi G, Vega-Ostertag M, Liu X, Espinola RG, Salmon J. Requirement of activation of complement C3 and C5 for antiphospholipid antibody- mediatedthrombophilia. Arthritis Rheum 2005;52:2120–4. DOI: https://doi.org/10.1002/art.21157
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Ghaneemah Malik Hamadi, Manal Badi Saleh
This work is licensed under a Creative Commons Attribution 4.0 International License.
which allows users to copy, create extracts, abstracts, and new works from the Article, alter and revise the Article, and make commercial use of the Article (including reuse and/or resale of the Article by commercial entities), provided the user gives appropriate credit (with a link to the formal publication through the relevant DOI), provides a link to the license, indicates if changes were made and the licensor is not represented as endorsing the use made of the work.
