purpose: The role that circulating anti-DNA immune complexes play in autoimmunity has not yet been elucidated in humans. The aim of this study was to relate circulating anti-DNA immune complexes to a variety of renal histologic features and to immunoglobulin deposits in active lupus nephritis. patients and methods: The study population consisted of 47 patients with active lupus nephritis, 28 with active systemic lupus erythematosus (SLE) in the absence of renal lesions, and 40 with other categories of the disease. All patients were examined for anti-DNA circulating immune complexes (CIC) and their anti-DNA idiotype expression by an isoelectrofocusing analysis. Patients with renal lesions were also examined for renal histologic and immunofluorescent findings in renal biopsy specimens. results: Anti-DNA CIC expressing an antiDNA idiotype termed 0-81 Id occurred in patients with active lupus nephritis but not in acute episodes lacking renal involvement or in remission. Positive test results for anti-DNA CIC were associated with the incidence of diffuse proliferative glomerulonephritis (DPGN). Patients with anti-DNA CIC were also found to have a statistically significant increase in the prevalence of immunoglobulin immune deposits in the subendothelial area of the renal glomeruli. conclusion: The findings suggest that antiDNA CIC preferentially occurred in lupus patients with DPGN. Examination for anti-DNA CIC may be a useful predictor of renal lesions, and therefore may contribute to the management of SLE. The results also indicate that anti-DNA CIC may be associated with immunoglobulin deposition in the subendothelial area of the renal glomeruli.
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