Main Article Content

Abstract

Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease with various underlying mechanisms characterized by autoantibody overproduction. It has been known that mortality and morbidity of SLE was higher in Asian patients compared with white patients. Several studies had showed that C-reactive protein (CRP) has the ability to suspend the progression of SLE through regulatory and clearance pathway, and low level of CRP and high level of anti-CRP antibody has been detected in SLE patients. A question raise whether mortality and morbidity in Asian SLE patients are associated with anti-CRP antibody.

Objective: To study the prevalence of anti-CRP antibody and its relationship with disease activity in SLE patients at Cipto Mangunkusumo General Hospital,Jakarta.

Methods: This is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital from December 2009 until May 2010. Subjects were SLE patients who
were diagnosed based on the 1982 American College of Rheumatology criteria. Disease activity was measured using the Mexican SLE Disease Activity Index scoring
system. Anti-CRP antibody assay was performed using the Western blot analysis. Correlation between the presence of anti-CRP antibody and disease activity
was evaluated using the T-test and multivariate logistic regression analysis.

Result: Forty SLE patients with a mean age of 31.65 (SD 8.84) were enrolled in the study, 33 of which (82.5%) had positive autoantibody to CRP pentamer. The anti-CRP antibody was signifi cantly correlated (p = 0.024) with disease activity.

Conclusions: There was a relatively large proportion of patients with positive anti-CRP antibody among SLE patients in Cipto Mangunkusumo General Hospital. There
was also a signifi cant correlation between anti-CRP antibody and the disease activity.

Article Details

How to Cite
Lusiani, L., Setiyohadi, B., Sukmana, N., & Abdullah, M. (2018). Prevalence of anti–C-reactive protein autoantibody and its correlation with disease activity in systemic lupus erythematosus patients at Cipto Mangunkusumo General Hospital. Indonesian Journal of Rheumatology, 2(2). https://doi.org/10.37275/ijr.v2i3.81

References

  1. Jiménez S, Cervera R, Font J, Ingelmo M. The epidemiology of systemic lupus erythematosus. Clin Rev Allergy Immunol 2003;25(1):3–12.
  2. Gupta R, Lim K. The diagnosis of systemic lupus erythematosus: how the laboratory can help you. CPD Rheumatol 2001;2(2):47–52.
  3. Samanta A, Roy S, Feehally J, Symmons DPM. The prevalence of diagnosed systemic lupus erythematosus in whites and Indian Asian immigrants in Leicester City, UK. Br J Rheumatol 1992;31:679–82.
  4. Samanta A, Feehally J, Roy S, Nichol FE, Sheldon PJ, Walls J. High prevalence of systemic disease and mortality in Asian subjects with systemic lupus erythematosus. Ann Rheum Dis 1991;50:490–2.
  5. Danchenko N, Satia JA, Anthony MS. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus 2006;15:308–18.
  6. Bell SA, Faust H, Schmid A, Meurer M. Autoantibodies to C-rreactive protein (CRP) and other acute-phase proteins in systemic autoimmune disease. Clin Exp Immunol 1998;113:327-32.
  7. Sjöwall C, Bengtsson T, Skogh T. CRP and anti-CRP autoantibodies in systemic lupus erythematosus. Curr Rheumatol Rev 2005;1:81–9.
  8. Fischbacher CM, Bhopal R, Blackwell CC, Ingram R, Unwin NC, White M, et al. IgG is higher in South Asians than Europeans: Does infection contribute to ethnic variation in cardiovascular disease? Arterioscler Thromb Vasc Biol 2003;23:703–4.
  9. Guzmán J, Cardiel MH, Arce-Salinas A, Sánchez-Guerrero J, AlarcónSegovia D. Measurement of disease activity in systemic lupus erythematosus. Prospective validation of 3 clinical indices. J Rheumatol1992;19:1551–8.
  10. Kakati S, Doley B, Kumar PS. C-reactive protein in systemic lupus erythematosus. J Indian Rheumatol Assoc 2003;11:66–70.
  11. Jiménez S, Cervera R, Font J, Ingelmo M. The epidemiology of systemic lupus erythematosus. Clin Rev Allergy Immunol 2003;25(1):3–12.
  12. Juariah N. Profi le and fi ve-year survival analysis of systemic lupus erythematosus patients in Cipto Mangunkusumo General Hospital in 1990–2007 [Profi l dan kesintasan lima tahun pada pasien lupus eritematosus sistemik di RSCM tahun 1990–2007] [specialist thesis].[Jakarta]: University of Indonesia School of Medicine;2008.
  13. Ndiaye FS, Ndongo S, Fall S, Lèye Y, Dioum A, Ka MM, et al. Frequency of hematological and immunological manifestations of lupus in Dakar. Dakar Med 2008;53:192–7.
  14. Doria A, Shoenfeld Y, Gambari PF, Puato M, Ghirardello A, Gilburd B. Risk factor for subclinical atherosclerosis in a prospective cohort of patients with systemic lupus erythematosus. Ann Rheum Dis 2003;62:1071–7.
  15. Oliviera EB, Gotschlich C, Liu TY. Primary structure of human C-reactive protein. J Biol Chem 1979;254:489–502.
  16. Sjöwall C, Bengtsson AA, Sturfelt G, Skogh T. Serum levels of autoantibodies against monomeric C-reactive protein are correlated with disease activity in systemic lupus erythematosus. Arthritis Res Ther2004;6:R87–R94.
  17. Lee HG, Kim YH, Lee HS, Choi MJ, Choe IS, Chung TW. A simplifi ed procedure for C-reactive protein purifi cation. Korean Biochem J1989;22:448–54.
  18. Llorente L, Zou W, Levy Y, Richaud-Patin Y, Wijdenes J, Alcocer-Varela J, et al. Role of interleukin-10 in the B lymphocyte hyperactivity and autoantibody production of human systemic lupus erythematosus. J ExpMed 1995: 839–44.
  19. Barreto M, Ferreira RC, Lourenço L, Moraes-Fontes MF, Santos E, Miguel Alves M, et al. Low frequency of CD4+CD25+ Treg in SLE patients: a heritable trait associated with CTLA4 and TGFß gene variants. BMC Immunol 2009;10:5.

Most read articles by the same author(s)