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The prognostic significance in Goodpasture's disease of specificity, titre and affinity of anti-glomerular-basement-membrane antibodies.

Segelmark, Mårten LU ; Hellmark, Thomas LU and Wieslander, Jörgen (2003) In Nephron Clinical Practice 94(3). p.59-68
Abstract
Background: The nephrotoxic potential of anti-glomerular-basement-membrane (GBM) antibodies has been demonstrated in numerous animal experiments. However, it is not known to what extent the properties of circulating anti-GBM antibodies in human disease reflect the severity of the disease and predict the outcome. Methods: Clinical data were collected for 79 Swedish patients for whom a positive result had previously been obtained with anti-GBM ELISA. In stored sera from the patients, we measured antibody concentration, specificity and affinity together with antineutrophil cytoplasmic antibodies and alpha(1)-antitrypsin phenotype. Results: Six months after diagnosis, 27 (34%) were dead, 32 (41%) were on dialysis treatment and only 20 (25%)... (More)
Background: The nephrotoxic potential of anti-glomerular-basement-membrane (GBM) antibodies has been demonstrated in numerous animal experiments. However, it is not known to what extent the properties of circulating anti-GBM antibodies in human disease reflect the severity of the disease and predict the outcome. Methods: Clinical data were collected for 79 Swedish patients for whom a positive result had previously been obtained with anti-GBM ELISA. In stored sera from the patients, we measured antibody concentration, specificity and affinity together with antineutrophil cytoplasmic antibodies and alpha(1)-antitrypsin phenotype. Results: Six months after diagnosis, 27 (34%) were dead, 32 (41%) were on dialysis treatment and only 20 (25%) were alive with a functioning native kidney. The best predictor for renal survival was renal function at diagnosis. In patients who were not dialysis dependent at diagnosis however, renal survival was associated with a lower concentration of anti-GBM antibodies, a lower proportion of antibodies specific for the immunodominant epitope and the histological severity of the renal lesion. The only factor that correlated with patient survival was age. Conclusions: Immunochemical properties of autoantibodies do not affect patient survival in anti-GBM disease but seem to be a factor in renal survival in patients detected before renal damage is too advanced. Copyright (C) 2003 S. Karger AG, Basel. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Goodpasture's syndrome, anti-glomerular-basement-membrane antibodies, glomerular, antineutrophil cytoplasmic antibodies, glomerulonephritis, basement membrane
in
Nephron Clinical Practice
volume
94
issue
3
pages
59 - 68
publisher
Karger
external identifiers
  • wos:000186540200003
  • pmid:12902632
ISSN
1660-2110
DOI
10.1159/000072022
language
English
LU publication?
yes
id
50f9ba4d-4456-40b6-98af-4d4529c99f3b (old id 117498)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12902632&dopt=Abstract
date added to LUP
2007-06-28 15:39:56
date last changed
2016-04-15 20:36:44
@article{50f9ba4d-4456-40b6-98af-4d4529c99f3b,
  abstract     = {Background: The nephrotoxic potential of anti-glomerular-basement-membrane (GBM) antibodies has been demonstrated in numerous animal experiments. However, it is not known to what extent the properties of circulating anti-GBM antibodies in human disease reflect the severity of the disease and predict the outcome. Methods: Clinical data were collected for 79 Swedish patients for whom a positive result had previously been obtained with anti-GBM ELISA. In stored sera from the patients, we measured antibody concentration, specificity and affinity together with antineutrophil cytoplasmic antibodies and alpha(1)-antitrypsin phenotype. Results: Six months after diagnosis, 27 (34%) were dead, 32 (41%) were on dialysis treatment and only 20 (25%) were alive with a functioning native kidney. The best predictor for renal survival was renal function at diagnosis. In patients who were not dialysis dependent at diagnosis however, renal survival was associated with a lower concentration of anti-GBM antibodies, a lower proportion of antibodies specific for the immunodominant epitope and the histological severity of the renal lesion. The only factor that correlated with patient survival was age. Conclusions: Immunochemical properties of autoantibodies do not affect patient survival in anti-GBM disease but seem to be a factor in renal survival in patients detected before renal damage is too advanced. Copyright (C) 2003 S. Karger AG, Basel.},
  author       = {Segelmark, Mårten and Hellmark, Thomas and Wieslander, Jörgen},
  issn         = {1660-2110},
  keyword      = {Goodpasture's syndrome,anti-glomerular-basement-membrane antibodies,glomerular,antineutrophil cytoplasmic antibodies,glomerulonephritis,basement membrane},
  language     = {eng},
  number       = {3},
  pages        = {59--68},
  publisher    = {Karger},
  series       = {Nephron Clinical Practice},
  title        = {The prognostic significance in Goodpasture's disease of specificity, titre and affinity of anti-glomerular-basement-membrane antibodies.},
  url          = {http://dx.doi.org/10.1159/000072022},
  volume       = {94},
  year         = {2003},
}