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      The Role of Anti-mCRP Autoantibodies in Lupus Nephritis

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          Abstract

          Background

          Lupus nephritis is characterized by multiple autoantibodies production. However, there are few autoantibodies associated with disease activity and prognosis. CRP exists in at least two conformationally distinct forms: native pentameric C-reactive protein (pCRP) and modified/monomeric CRP (mCRP). Autoantibodies against mCRP are prevalent in sera of patients with lupus nephritis and are reported to be pathogenic.

          Summary

          The levels of serum anti-mCRP autoantibodies are associated with clinical disease activity, tubulointerstitial lesions, treatment response, and prognosis in patients with lupus nephritis. The key epitope of mCRP was amino acid 35–47. Furthermore, emerging evidence indicated that anti-mCRP autoantibodies could participate in the pathogenesis of lupus nephritis by forming in situ immune complexes or interfering with the biological functions of mCRP, such as binding to complement C1q and factor H.

          Key Messages

          Here, we review the recent advances in the prevalence, clinical-pathological associations, and potential pathogenesis of anti-mCRP autoantibodies in lupus nephritis, which may provide a promising novel therapeutic strategy for lupus nephritis.

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          Most cited references89

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          Systemic lupus erythematosus.

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            C-reactive protein: a critical update.

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              Lupus nephritis

              Lupus nephritis (LN) is a form of glomerulonephritis that constitutes one of the most severe organ manifestations of the autoimmune disease systemic lupus erythematosus (SLE). Most patients with SLE who develop LN do so within 5 years of an SLE diagnosis and, in many cases, LN is the presenting manifestation resulting in the diagnosis of SLE. Understanding of the genetic and pathogenetic basis of LN has improved substantially over the past few decades. Treatment of LN usually involves immunosuppressive therapy, typically with mycophenolate mofetil or cyclophosphamide and with glucocorticoids, although these treatments are not uniformly effective. Despite increased knowledge of disease pathogenesis and improved treatment options, LN remains a substantial cause of morbidity and death among patients with SLE. Within 10 years of an initial SLE diagnosis, 5-20% of patients with LN develop end-stage kidney disease, and the multiple comorbidities associated with immunosuppressive treatment, including infections, osteoporosis and cardiovascular and reproductive effects, remain a concern. Clearly, early and accurate diagnosis of LN and prompt initiation of therapy are of vital importance to improve outcomes in patients with SLE.
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                Author and article information

                Journal
                Kidney Dis (Basel)
                Kidney Dis (Basel)
                KDD
                KDD
                Kidney Diseases
                S. Karger AG (Basel, Switzerland )
                2296-9381
                2296-9357
                15 May 2023
                October 2023
                : 9
                : 5
                : 317-325
                Affiliations
                [a ]Renal Division, Peking University First Hospital, Beijing, China
                [b ]Institute of Nephrology, Peking University, Beijing, China
                [c ]Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
                [d ]Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China
                [e ]Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China
                [f ]School of Medicine, Yunnan University, Kunming, China
                [g ]Department of Pathology, Affiliated Hospital of Yunnan University, Second People’s Hospital of Yunnan Province, Kunming, China
                Author notes
                Correspondence to: Ying Tan, tanying@ 123456bjmu.edu.cn
                Article
                530928
                10.1159/000530928
                10601961
                db65f0eb-3e46-45bb-a592-320e01c71e7e
                © 2023 The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ( http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.

                History
                : 16 December 2022
                : 17 April 2023
                : 2023
                Page count
                Figures: 1, Tables: 3, References: 89, Pages: 9
                Funding
                This work was supported by grants from the Beijing Natural Science Foundation (No. 7192207), the National Natural Science Foundation of China (No. 81870479), and the CAMS Innovation Fund for Medical Sciences (No. 2019-I2 M-5-046).
                Categories
                Review Article

                systemic lupus erythematosus,lupus nephritis,anti-mcrp autoantibodies,pathogenesis

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