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Clinical and Serological Correlates of Serum C1Q and Anti-C1Q Antibodies in South Africans With Systemic Lupus Erythematosus

Tikly, Mohammed ; Skattum, Lillemor LU and Makda, Mohamed Amin (2025) In Journal of Clinical Laboratory Analysis 39(18).
Abstract

Objective: To investigate prevalence and clinical correlates of serum C1q and anti-C1q antibody titres in black South Africans with systemic lupus erythematosus (SLE). Methods: Cross-sectional study of 96 SLE patients, 49 with lupus nephritis (LN). Anti-C1q antibodies were tested by ELISA. Serum C1q was measured as a percentage of normal by immunoelectrophoresis. Disease activity was assessed using the SELENA-SLE disease activity index. Results: Most patients were female (90.7%), mean (SD) age and follow-up period diagnosis of 38.1 (13.0) and 4.2 (4.4) years, respectively. Low serum C1q and positive anti-C1q antibody test were detected in 17 (17.7%) and 12 (12.5%) patients, respectively, overall. There was an inverse correlation between... (More)

Objective: To investigate prevalence and clinical correlates of serum C1q and anti-C1q antibody titres in black South Africans with systemic lupus erythematosus (SLE). Methods: Cross-sectional study of 96 SLE patients, 49 with lupus nephritis (LN). Anti-C1q antibodies were tested by ELISA. Serum C1q was measured as a percentage of normal by immunoelectrophoresis. Disease activity was assessed using the SELENA-SLE disease activity index. Results: Most patients were female (90.7%), mean (SD) age and follow-up period diagnosis of 38.1 (13.0) and 4.2 (4.4) years, respectively. Low serum C1q and positive anti-C1q antibody test were detected in 17 (17.7%) and 12 (12.5%) patients, respectively, overall. There was an inverse correlation between serum C1q and anti-C1q antibodies titres (r = −0.22, p = 0.03) and a direct correlation of anti-C1q antibodies titres with SELENA-SLEDAI scores (r = 0.27, p = 0.008). Patients with an active urine sediment (n = 21) had higher anti-C1q antibodies titres (p = 0.007) and low serum C1q (OR = 4.51, p = 0.01), compared to the remainder of patients. Anti-C1q antibody titres were higher in patients with C3/C4 hypocomplementaemia (n = 14) than those with normal C3/C4 (p = 0.02). A positive Coombs test (without evidence of red cell haemolysis) (n = 17) was associated with a positive anti-C1q antibody test (OR = 4.29, p = 0.02), low serum C1q (OR = 3.37, p = 0.04) and C3/C4 hypocomplementaemia (OR = 4.84, p = 0.02). Conclusion: Our findings broadly confirm the clinical utility of the anti-C1q antibody test in SLE. Raised anti-C1q antibody titres were associated with active LN, as evidenced by an active urine sediment. The association of a positive anti-C1q antibody and low serum C1q with a positive Direct Coombs' test merits further study and confirmation.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Africa, anti-C1q antibodies, direct coombs test, systemic lupus erythematosus
in
Journal of Clinical Laboratory Analysis
volume
39
issue
18
article number
e70087
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:40719289
  • scopus:105011861637
ISSN
0887-8013
DOI
10.1002/jcla.70087
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.
id
dcde74b4-6479-4b67-9f54-b69b1dd27e14
date added to LUP
2026-01-08 15:02:38
date last changed
2026-01-08 15:03:48
@article{dcde74b4-6479-4b67-9f54-b69b1dd27e14,
  abstract     = {{<p>Objective: To investigate prevalence and clinical correlates of serum C1q and anti-C1q antibody titres in black South Africans with systemic lupus erythematosus (SLE). Methods: Cross-sectional study of 96 SLE patients, 49 with lupus nephritis (LN). Anti-C1q antibodies were tested by ELISA. Serum C1q was measured as a percentage of normal by immunoelectrophoresis. Disease activity was assessed using the SELENA-SLE disease activity index. Results: Most patients were female (90.7%), mean (SD) age and follow-up period diagnosis of 38.1 (13.0) and 4.2 (4.4) years, respectively. Low serum C1q and positive anti-C1q antibody test were detected in 17 (17.7%) and 12 (12.5%) patients, respectively, overall. There was an inverse correlation between serum C1q and anti-C1q antibodies titres (r = −0.22, p = 0.03) and a direct correlation of anti-C1q antibodies titres with SELENA-SLEDAI scores (r = 0.27, p = 0.008). Patients with an active urine sediment (n = 21) had higher anti-C1q antibodies titres (p = 0.007) and low serum C1q (OR = 4.51, p = 0.01), compared to the remainder of patients. Anti-C1q antibody titres were higher in patients with C3/C4 hypocomplementaemia (n = 14) than those with normal C3/C4 (p = 0.02). A positive Coombs test (without evidence of red cell haemolysis) (n = 17) was associated with a positive anti-C1q antibody test (OR = 4.29, p = 0.02), low serum C1q (OR = 3.37, p = 0.04) and C3/C4 hypocomplementaemia (OR = 4.84, p = 0.02). Conclusion: Our findings broadly confirm the clinical utility of the anti-C1q antibody test in SLE. Raised anti-C1q antibody titres were associated with active LN, as evidenced by an active urine sediment. The association of a positive anti-C1q antibody and low serum C1q with a positive Direct Coombs' test merits further study and confirmation.</p>}},
  author       = {{Tikly, Mohammed and Skattum, Lillemor and Makda, Mohamed Amin}},
  issn         = {{0887-8013}},
  keywords     = {{Africa; anti-C1q antibodies; direct coombs test; systemic lupus erythematosus}},
  language     = {{eng}},
  number       = {{18}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Journal of Clinical Laboratory Analysis}},
  title        = {{Clinical and Serological Correlates of Serum C1Q and Anti-C1Q Antibodies in South Africans With Systemic Lupus Erythematosus}},
  url          = {{http://dx.doi.org/10.1002/jcla.70087}},
  doi          = {{10.1002/jcla.70087}},
  volume       = {{39}},
  year         = {{2025}},
}