Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0409974 (lupus)
 22,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

163 patients with diffuse lupus glomerulonephritis, proven by renal biopsy, were divided into four therapeutic trial groups: 67 were put on corticosteroids alone, 11 on corticosteroids and azathioprine, 32 on corticosteroids and cyclophosphamide, and 53 on corticosteroids and chlorambucil and were followed up for several years. The addition of azathioprine to corticosteroids did not increase the survival rate, improve the renal function or alter the grim prognosis of the patients. Cyclophosphamide appeared to influence favourably the pathological lesion and the renal function when added to corticosteroids, and the disease progressed at a slower rate. The fatal side effects nearly balanced the therapeutic value of cyclophosphamide. Patients on corticosteroids and chlorambucil had an excellent course. This therapeutic regimen resulted in resolution or regression of the renal pathology, marked improvement of the renal function and marked improvement of the survival rate. The authors believe that this therapeutic regimen holds the best chance of becoming the standard treatment for lupus nephritis, particularly since the side effects of chlorambucil were minimal.
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PMID:Comparison of chlorambucil, azathioprine or cyclophosphamide combined with corticosteroids in the treatment of lupus nephritis. 8 55

Circulating immune complexes (CIC) were measured by three different methods in serum from 17 patients with systemic lupus erythematosus (SLE), 3 patients with "hydralazine-induced" SLE-like syndromes, 14 patients with discoid lupus (DLE), 8 patients with systemic sclerosis and 5 patients with dermatomyositis. Immune complexes were detected in 13 of the 17 patients with SLE. All patients with lupus nephritis and typical exanthema had circulating immune complexes. The concentration of immune complexes was inversely correlated to serum complements C4 and C3. All 3 patients with "hydralazine-induced" SLE-like syndromes had circulating immune complexes that disappeared after withdrawal of the drug. Immune complexes were detected in 3 of the 14 patients with DLE; all 3 patients with CIC had wide-spread DLE. In systemic sclerosis, CIC were detected in only 1 of the 8 patients. Four of the 5 patients with dermatomyositis demonstrated CIC in serum. No complement consumption was detected in dermatomyositis and the immune complexes may have been secondary to tissue destruction.
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PMID:Circulating immune complexes in lupus erythematosus, scleroderma and dermatomyositis. 9 65

A patient with systemic lupus erythematosus (SLE), followed up over a six-month period, exhibited numerous immunologic abnormalities and varied renal pathologic features. Initial findings included minimal glomerular lesions, serum antibodies directed solely against nuclear RNA protein, and lupus band test showing pure IgM deposition. These findings suggested a good prognosis. Subsequently, the patient developed acute renal failure secondary to an interstitial lupus nephritis, without progression of the glomerular abnormality. Serum antibodies to the nuclear non-nucleic acid macromolecule and single stranded and native DNA were demonstrated concurrently. New skin deposits of IgG and IgA in addition to IgM also were observed. This patient demonstrates the potential progression of lupus renal disease despite the initial favorable prognostic indicators.
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PMID:Acute renal failure secondary to interstitial lupus nephritis. 30 20

Detailed immunopathologic studies of early or silent renal alterations in systemic lupus erythematosus have been sparse. The renal biopsies of 16 lupus patients with normal renal function, including 8 with hematuria and/or proteinuria of recent onset, and 8 without clinically detectable renal disease were investigated by light, immunofluorescence, and electron microscopy. Immunoglobulins, complement components, and electron-dense deposits were detected in glomeruli of all patients, regardless of morphologic appearance or lack of clinical evidence of renal involvement. Features of membranous glomerulonepritis were observed in 4 patients with substantial proteinuria. In the remaining 12 patients, including 3 with hematuria and 4 with slight proteinuria, either minimal glomerular alterations or features of mesangial proliferative glomerulonephritis were seen. Transformation of the original disease was demonstrated in 3 of 3 patients rebiopsied within 2 years. The significance of these findings is discussed in relation to a) the spectrum of clinical and immunopathologic alterations in lupus nephritis and b) transformation of the original disease.
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PMID:Immunopathology of early and clinically silent lupus nephropathy. 32 2

The clinical value of the Crithidia luciliae (CL) method for detection of antibodies to native DNA (nDNA) was assessed. Significant titers were limited almost exclusively to patients with active systemic lupus erythematosus (SLE). Evaluation of sera from patients at the onset of active lupus demonstrated elevated anti-nDNA levels in 80% of subjects with active disease and in 94% of patients with clinically evident lupus nephritis. In longitudinal studies, rising titers of anti-nDNA were invariably accompanied by exacerbation of lupus activity. These findings suggest that the CL method correlates more closely with active SLE than do other anti-DNA methods in common use and indicate that it will prove highly useful in the diagnosis and management of SLE.
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PMID:Anti-native DNA detection by the Crithidia luciliae method: an improved guide to the diagnosis and clinical management of systemic lupus erythematosus. 37 28

Antibodies to double-stranded deoxyribonucleic acid were studied using the kinetoplast of Crithidia luciliae. Titers were determined separately by conventional immunofluorescence and the complement fluorescent technique, and results by the two methods were compared. Complement fixing activity varied independently of antibody content in whole serum and in IgG fractions. The well established correlation of complement fixing activity of this antibody with activity of lupus nephritis appears related, therefore, to qualitative rather than solely quantitative differences. This finding has important implications for the clinical assessment of patients with lupus, and investigations on the relationship of anti-DNA antibodies to lupus nephritis.
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PMID:IgG antibodies to double-stranded DNA in systemic lupus erythematosus sera. Independent variation of complement fixing activity and total antibody content. 37 38

To investigate the suggestion that qualitative immunochemical characteristics of antibodies to DNA (anti-DNA) may be of importance in the pathogenesis of nephritis in systemic lupus erythematosus (SLE), we used the Crithidia luciliae (CL) immunofluorescence test to determine the titre, immunoglobulin (Ig) class and complement-fixing activity of anti-DNA in thirty-five patients with active SLE. Eighteen of these patients had active lupus nephritis (Group I) and the remaining seventeen had no clinical evidence of renal involvement (Group II). Anti-DNA was detected in twenty-eight patients, and was present more frequently and in higher titre (P less than 0.01) in Group I than in Group II. Anti-DNA of all three Ig classes studied (IgG, IgM and IgA) was present in twenty-three out of twenty-eight cases. The ratio of IgG to IgM anti-DNA did not differ in the two groups of patients. Complement-fixing antibodies were detected in thirteen patients in Group I and five patients in Group II. The titre of complement-fixing activity was strongly correlated with titre of anti-DNA. DNA-binding capacity was also determined in these by a millipore filter (MF) assay. A highly significant correlation between DNA binding by MF and CL was found in Group I patients, while no correlation was found in Group II patients. These findings suggest that (1) anti-DNA with specificity for determinants found in CL, presumably native DNA, are more highly correlated with the presence of active renal lupus than are antibodies directed toward other DNA determinants, and (2) the major characteristic of anti-DNA found to be associated with nephritis was quantity of antibody. Most patients had anti-DNA of all Ig classes regardless of the presence of renal disease. Complement-fixing activity of anti-DNA could not be related to the occurrence of renal disease independently of anti-DNA titre.
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PMID:Immunochemical characteristics of antibodies to DNA in patients with active systemic lupus erythematosus. 38 88

Seventy-one patients with systemic lupus erythematosus and clinical evidence of nephritis were seen during a 15-year period, and followed for a mean of seven years. Survival was calculated to be 76 per cent at five years and 57 per cent at ten years from onset of clinical nephritis; and 80, 65, 55 and 55 per cent five, ten, fifteen and twenty years from onset of clinical lupus. Renal biopsies showed mild or focal lesions in 30 per cent of patients, membranous lesions in 14 per cent and diffuse proliferative lesions in 55 per cent. However, there was no difference in the long-term outcome of the different histological groups. Nineteen patients (27 per cent) died during follow up, eleven from renal failure, six from sepsis and two from cerebral lupus. Death in renal failure is now usually a late event in lupus, even in patients with clinical evidence of severe nephritis. The prognosis of even severe lupus nephritis is now better than formerly reported. Reducing the dose of corticosteroid drugs, by the use of cytotoxic drugs such as azathioprine may have diminished the mortality from cardiovascular complications. Side effects of treatment, however, remain an important cause of death and morbidity.
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PMID:Systemic lupus with nephritis: a long-term study. 48 85

A prospective study was carried out in 25 patients with systemic lupus erythematosis (SLE) on the effect of normalizing serum complement (CH50) and anti-DNA antibodies on the course of lupus nephritis. In 16 of the 25 patients, CH50 was maintained within the normal range for two years. Urinary protein excretion increased or remained low in all 16. Repeat renal biopsies were performed in 10 of these 16, and disclosed either stabilization of glomerular disease or diminution. In the nine patients in whom CH50 could not be normalized with tolerated doses of drugs, urinary protein excretion increased or remained increased. Repeat renal biopsies in six of these nine patients were carried out and showed worsening of glomerular disease in five. No clear-cut correlation was found between urinary protein excretion or renal disease and the serum levels of anti-DNA antibody. We conclude from these observations that continuous normalization of CH50 by drug therapy in patients with SLE is associated with stabilization or diminution of lupus nephritis.
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PMID:The effect of normalization of serum complement and anti-DNA antibody on the course of lupus nephritis: a two year prospective study. 62 76

The role of antibodies to Sm and RNP in renal diseases in SLE was investigated using counter immunoelectrophoresis (CIE). Antibody to RNP was found in about 50% of lupus patients irrespective of the degree of renal involvement as evaluated clinically, histologically and immunopathologically. Antibody to Sm was found more frequently in lupus patients with renal lesions than in those without renal disease. Antibody to RNP was demonstrated in 8 of 10 (80%) and antibody to Sm in 4 of 10 (40%) specimens obtained by elution of autopsied kidneys. These results suggest that antibodies to RNP and Sm are also of importance in the pathogenesis of lupus nephritis in addition to the already recognized role of antibody to ds-DNA.
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PMID:The correlation of antibodies to nuclear ribonucleoprotein (RNP) and nuclear acidic protein (Sm) with nephritis in patients with systemic lupus erythematosus (SLE). 66 85


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