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Doctoral Thesis
Full name
Patrícia Andrade de Macêdo
Knowledge Area
Date of Defense
São Paulo, 2013
Bonfa, Eloisa Silva Dutra de Oliveira (President)
Andrade, Danieli Castro Oliveira de
Goncalves, Celio Roberto
Pasoto, Sandra Gofinet
Reis Neto, Edgard Torres dos
Title in Portuguese
Anticorpo anti-P ribossomal em pacientes com glomerulonefrite lúpica: marcador de melhor sobrevida renal?
Keywords in Portuguese
Análise de sobrevida
Lúpus eritematoso sistêmico
Marcadores biológicos
Proteínas ribossômicas/imunologia
Abstract in Portuguese
O anticorpo anti-proteína P ribossomal é um dos marcadores sorológicos do lúpus eritematoso sistêmico, previamente associado a glomerulonefrite lúpica classe V (ISN-RPS). Neste trabalho foi avaliado o prognóstico renal em pacientes que possuem positividade para este anticorpo. Sessenta pacientes foram avaliados para parâmetros de sobrevida renal. Onze pacientes (18%) apresentaram positividade sorológica exclusiva para anticorpo anti-P ribossomal e vinte e oito pacientes (47%) para anti-dsDNA. Ao final do período de seguimento, foi observado que os pacientes anti-P positivos apresentaram uma maior sobrevida renal (11,0 ± 4,5 vs. 9,2 ± 4,5 anos, p=0,03) quando comparados aqueles anti-P negativos, assim como menor frequência de necessidade de terapia substitutiva renal (0 vs. 35% p = 0,025). Pacientes anti-P positivos apresentaram também maior frequência de classe V (91% vs. 31%, p < 0.001) e menor incidência de alterações proliferativas (45% vs. 82%, p = 0,021) na avaliação da biópsia renal quando comparados aos pacientes sem a positividade para este anticorpo. Os dados reforçam a hipótese de que o anticorpo anti-P é um marcador útil de um melhor prognóstico renal em pacientes portadores de lúpus eritematoso sistêmico
Title in English
Antibodies to ribossomal P proteins in lúpus nephritis: a surrogate marker for a better renal survival?
Keywords in English
Biological markers
Lupus erythematosus systemic
Ribossomal proteins/immunology
Survival analysis
Abstract in English
Antibodies to ribossomal P proteins are one of the serologic markers of systemic lupus erythematosus, previously described as associated to class V lupus glomerulonephritis (ISN-RPS). Our study assessed renal prognosis in patients with anti-P antibodies. Sixty consecutive SLE patients with biopsyproven nephritis (2004 ISN/RPS) were evaluated for renal survival parameters. Eleven patients (18%) had exclusive anti-P positivity and 28 (47%) patients anti-dsDNA. The post-biopsy follow-up analysis demonstrated that anti-P positive patients disclosed better renal survival (11.0 ± 4.5 vs. 9.2 ± 4.5 years, p = 0.03) as well as lower frequency of patients requiring dialysis (0 vs. 35% p = 0.025). The frequency of class V nephritis was higher in anti-P positive patients (91% vs. 31%, p < 0.001) and the occurrence of proliferative lesions at biopsy was lower in these patients (45% vs. 82%, p=0.021). Our data supports the notion that anti-P antibody is a valuable marker to predict a better long-term renal outcome in lupus patients
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