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a Centre For
Rheumatology/ Bloomsbury Rheumatology Unit, Department of Medicine
University College London, b Departments of
Statistics, University College, London, c Molecular Immunology Group, Tenovus Laboratory, Southampton
University Hospitals, Southampton
Correspondence to: Professor D Isenberg, Bloomsbury Rheumatology Unit, Middlesex Hospital, Arthur Stanley House, 50 Tottenham Street, London W1P 9PG.
Accepted for publication 20 July 1998
OBJECTIVE
To compare the levels of the 9G4
idiotope (9G4 Id) in systemic lupus erythematosus (SLE) patients with a
detailed disease activity index, the British Isles Lupus Assessment
Group (BILAG) index, and serological parameters of disease activity by
ds DNA antibody levels and serum C3 concentrations.
METHODSIn a cross sectional analysis serum
samples from 190 patients with SLE were studied and a further 55 serial
bleeds from 14 patients. An enzyme linked immunosorbent assay was used
to measure the 9G4 Id, and anti dsDNA and anti-myeloperoxidase (MPO)
antibodies. The C3 levels were measured by laser nephelometer.
RESULTSSeventy six of 190 (40%) of the patients
tested had raised 9G4 Id levels. In the cross sectional study 9G4 Id
levels were found to correlate with disease activity in the BILAG
cardiovascular/respiratory renal, and haematological systems and with
global BILAG score (p<0.01). In the serial bleeds 9G4 Id levels
correlated with anti-dsDNA antibody and C3 levels, but not with
anti-MPO antibodies. No correlations were found with treatment. In six
cases the 9G4 Id levels correlated well with global BILAG scores and
dsDNA antibody levels. In four cases the BILAG global and 9G4 Id levels
alone correlated well.
CONCLUSIONSRaised levels of the 9G4 Id are
present in a substantial proportion of serum samples from patients with
lupus, correlate with various aspects of disease activity in SLE. The
Id is detectable on anti-dsDNA antibodies, though it must also be
present on other immunoglobulins whose specificities remain unknown.
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