ArticleArthritis research & therapy2017
Plasma C4d as marker for lupus nephritis in systemic lupus erythematosus.
Article in Arthritis research & therapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 47 citations in OpenAlex.
- Functional Characterization of a Novel Intronic Complement Factor I Variant in Factor I Deficiency and Atypical Hemolytic Uremic Syndrome.Kidney international reports · 2026Article
- Complement Dysregulation in Kidney Diseases: Mechanisms, Biomarkers, and Emerging Targeted Therapies.International journal of molecular sciences · 2026Review
- Complement activation in anti-glomerular basement membrane disease before and after treatment with imlifidase.Clinical kidney journal · 2026Article
- Proteolytic profiling of human plasma reveals an immunoactive complement C3 fragment.The EMBO journal · 2025Article
- Functional Roles of the Complement Immune System in Cardiac Inflammation and Hypertrophy.International journal of molecular sciences · 2025Review
- The relevance of complement levels in assessing the activity of lupus nephritis of different pathological types.Clinical rheumatology · 2025Article
- Association of C4d with disease activity in anti-neutrophil cytoplasmic antibody-associated vasculitis: evidence for classical/lectin complement pathway activation.Arthritis research & therapy · 2025Article
- Clinicopathological differences in the activation pattern of the complement system between pediatric and adult lupus nephritis: a single centered retrospective study in Korea.Childhood kidney diseases · 2025Article
- Complement factors as biomarkers in ANCA-associated vasculitis in remission.Clinical and experimental immunology · 2025Article
- Association between peripheral activated naive and double negative 2 B-cell subsets and clinical parameters in lupus nephritis patients.Scandinavian journal of immunology · 2025Article
- Biomarkers for systemic lupus erythematosus: A scoping review.Immunity, inflammation and disease · 2024Article
- Accurate Visualization of C4d Complement Fragment in Immunohistochemistry by C-Terminal Linear Neoepitope-Specific Antibodies.International journal of molecular sciences · 2024Article
- Early diagnosis and clinical application of systemic lupus erythematosus based on a nomogram model.Heliyon · 2024Article
- Lupus Nephritis Biomarkers: A Critical Review.International journal of molecular sciences · 2024Review
- Humoral complementomics - exploration of noninvasive complement biomarkers as predictors of renal cancer progression.Oncoimmunology · 2024Article
- Differentiating between activation via the lectin or the classical complement pathway in patients with systemic lupus erythematosus.Clinical and experimental immunology · 2023Article
- Serum RGC-32 in children with systemic lupus erythematosus.Scientific reports · 2023Article
- Complement as a Biomarker for Systemic Lupus Erythematosus.Biomolecules · 2023Review
- Evaluation of serum C4d levels in patients with systemic lupus erythematosus and its relation to lupus nephritis.Caspian journal of internal medicine · 2023Article
- Editorial: Complement and COVID-19 Disease.Frontiers in immunology · 2022Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundIn the present study, we sought to evaluate the complement activation product C4d as a marker for lupus nephritis in systemic lupus erythematosus (SLE).
methodsC4d levels were determined by enzyme-linked immunosorbent assay in plasma samples of patients with established SLE using a novel approach based on detection of a short linear cleavage neoepitope. Cross-sectional associations were studied in 98 patients with SLE with samples taken at lower or higher respective disease activity. Temporal associations were investigated in 69 patients with SLE who were followed longitudinally for up to 5 years. Plasma samples from 77 healthy donors were included as controls.
resultsC4d levels were negligible in healthy control subjects and significantly increased in patients with SLE in the cross-sectional study (p < 0.0001). C4d levels discriminated between higher and lower disease activity according to ROC curve analysis (p < 0.001), exhibiting a positive predictive value of 68%. At higher disease activity, C4d levels correlated with the modified Systemic Lupus Erythematosus Disease Activity Index (p = 0.011) and predominantly with lupus nephritis (p = 0.003), exhibiting a sensitivity of 79% to identify patients with nephritis. High C4d levels together with the presence of anti-dsDNA autoantibodies preceded and thus predicted future lupus nephritis in the longitudinal study (OR 5.4, 95% CI 1.4-21.3). When we considered only patients with renal involvement (19 of 69) during the longitudinal study, we found that high C4d levels alone could forecast recurrence of future lupus nephritis (OR 3.3, 95% CI 1.2-9.6).
conclusionsC4d appears to be a valuable marker for use in monitoring of patients with SLE, particularly for lupus nephritis. Importantly, C4d levels can predict impending flares of lupus nephritis and may thus be useful for informing treatment.
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