VH4-34 encoded antibodies in systemic lupus erythematosus: A specific diagnostic marker that correlates with clinical disease characteristics

Ronald F. Van Vollenhoven, Marcia M. Bieber, Michael J. Powell, Parul K. Gupta, Neelima M. Bhat, Kristy L. Richards, Shirley Albano-Aluquin, Nelson N.H. Teng

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Abstract

Objective. To determine the clinical significance of elevated serum levels of VH4-34 encoded antibodies (VH4-34 Ab) with respect to the diagnosis and clinical characteristics of systemic lupus erythematosus (SLE). Methods. Ninety-five patients with SLE and 344 controls were studied. The controls included 34 healthy individuals, 282 patients with nonautoimmune diseases, and 28 patients with autoimmune diseases other than SLE. VH4-34 Ab levels were measured by inhibition ELISA using anti-idiotope monoclonal antibody (9G4). SLE disease activity, severity, and damage were assessed by visual analog scales, Systemic Lupus Activity Measure, Lupus Severity of Disease Index, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Results. Fifty-two of 95 patients with SLE had elevated levels of VH4-34 Ab compared to 18 of 344 controls (5%), giving a sensitivity of 55% and a specificity of 95% for elevated VH4-34 Ab as a serologic test for SLE. The positive predictive value of elevated VH4-34 under these conditions was 7485%. In this study, anti-dsDNA was not VH4-34 encoded. Significant correlations between VH4-34 and disease activity and severity indices were observed (r = 0.29-0.50). The relative risk for severe disease in SLE patients with VH4-34 antibody level in the highest tertile compared to the lowest tertile was 5.25. Twenty-five of 29 patients with lupus nephritis and 6 of 6 patients with central nervous system (CNS) lupus had elevated VH4-34 Ab. Conclusion. With a specificity of 94-95%, the VH4-34 antibody assay may prove valuable as a confirmatory diagnostic test for SLE. In patients with known SLE, serum VH4-34 Ab levels correlate with overall disease severity and activity, but not damage, and with nephritis and CNS lupus.

Original languageEnglish (US)
Pages (from-to)1727-1733
Number of pages7
JournalJournal of Rheumatology
Volume26
Issue number8
StatePublished - Aug 15 1999

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Systemic Lupus Erythematosus
Antibodies
Central Nervous System Lupus Vasculitis
Lupus Nephritis
Nephritis
Serologic Tests
Serum
Visual Analog Scale
Routine Diagnostic Tests
Autoimmune Diseases
Enzyme-Linked Immunosorbent Assay
Monoclonal Antibodies

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Van Vollenhoven, R. F., Bieber, M. M., Powell, M. J., Gupta, P. K., Bhat, N. M., Richards, K. L., ... Teng, N. N. H. (1999). VH4-34 encoded antibodies in systemic lupus erythematosus: A specific diagnostic marker that correlates with clinical disease characteristics. Journal of Rheumatology, 26(8), 1727-1733.
Van Vollenhoven, Ronald F. ; Bieber, Marcia M. ; Powell, Michael J. ; Gupta, Parul K. ; Bhat, Neelima M. ; Richards, Kristy L. ; Albano-Aluquin, Shirley ; Teng, Nelson N.H. / VH4-34 encoded antibodies in systemic lupus erythematosus : A specific diagnostic marker that correlates with clinical disease characteristics. In: Journal of Rheumatology. 1999 ; Vol. 26, No. 8. pp. 1727-1733.
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abstract = "Objective. To determine the clinical significance of elevated serum levels of VH4-34 encoded antibodies (VH4-34 Ab) with respect to the diagnosis and clinical characteristics of systemic lupus erythematosus (SLE). Methods. Ninety-five patients with SLE and 344 controls were studied. The controls included 34 healthy individuals, 282 patients with nonautoimmune diseases, and 28 patients with autoimmune diseases other than SLE. VH4-34 Ab levels were measured by inhibition ELISA using anti-idiotope monoclonal antibody (9G4). SLE disease activity, severity, and damage were assessed by visual analog scales, Systemic Lupus Activity Measure, Lupus Severity of Disease Index, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Results. Fifty-two of 95 patients with SLE had elevated levels of VH4-34 Ab compared to 18 of 344 controls (5{\%}), giving a sensitivity of 55{\%} and a specificity of 95{\%} for elevated VH4-34 Ab as a serologic test for SLE. The positive predictive value of elevated VH4-34 under these conditions was 7485{\%}. In this study, anti-dsDNA was not VH4-34 encoded. Significant correlations between VH4-34 and disease activity and severity indices were observed (r = 0.29-0.50). The relative risk for severe disease in SLE patients with VH4-34 antibody level in the highest tertile compared to the lowest tertile was 5.25. Twenty-five of 29 patients with lupus nephritis and 6 of 6 patients with central nervous system (CNS) lupus had elevated VH4-34 Ab. Conclusion. With a specificity of 94-95{\%}, the VH4-34 antibody assay may prove valuable as a confirmatory diagnostic test for SLE. In patients with known SLE, serum VH4-34 Ab levels correlate with overall disease severity and activity, but not damage, and with nephritis and CNS lupus.",
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Van Vollenhoven, RF, Bieber, MM, Powell, MJ, Gupta, PK, Bhat, NM, Richards, KL, Albano-Aluquin, S & Teng, NNH 1999, 'VH4-34 encoded antibodies in systemic lupus erythematosus: A specific diagnostic marker that correlates with clinical disease characteristics', Journal of Rheumatology, vol. 26, no. 8, pp. 1727-1733.

VH4-34 encoded antibodies in systemic lupus erythematosus : A specific diagnostic marker that correlates with clinical disease characteristics. / Van Vollenhoven, Ronald F.; Bieber, Marcia M.; Powell, Michael J.; Gupta, Parul K.; Bhat, Neelima M.; Richards, Kristy L.; Albano-Aluquin, Shirley; Teng, Nelson N.H.

In: Journal of Rheumatology, Vol. 26, No. 8, 15.08.1999, p. 1727-1733.

Research output: Contribution to journalArticle

TY - JOUR

T1 - VH4-34 encoded antibodies in systemic lupus erythematosus

T2 - A specific diagnostic marker that correlates with clinical disease characteristics

AU - Van Vollenhoven, Ronald F.

AU - Bieber, Marcia M.

AU - Powell, Michael J.

AU - Gupta, Parul K.

AU - Bhat, Neelima M.

AU - Richards, Kristy L.

AU - Albano-Aluquin, Shirley

AU - Teng, Nelson N.H.

PY - 1999/8/15

Y1 - 1999/8/15

N2 - Objective. To determine the clinical significance of elevated serum levels of VH4-34 encoded antibodies (VH4-34 Ab) with respect to the diagnosis and clinical characteristics of systemic lupus erythematosus (SLE). Methods. Ninety-five patients with SLE and 344 controls were studied. The controls included 34 healthy individuals, 282 patients with nonautoimmune diseases, and 28 patients with autoimmune diseases other than SLE. VH4-34 Ab levels were measured by inhibition ELISA using anti-idiotope monoclonal antibody (9G4). SLE disease activity, severity, and damage were assessed by visual analog scales, Systemic Lupus Activity Measure, Lupus Severity of Disease Index, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Results. Fifty-two of 95 patients with SLE had elevated levels of VH4-34 Ab compared to 18 of 344 controls (5%), giving a sensitivity of 55% and a specificity of 95% for elevated VH4-34 Ab as a serologic test for SLE. The positive predictive value of elevated VH4-34 under these conditions was 7485%. In this study, anti-dsDNA was not VH4-34 encoded. Significant correlations between VH4-34 and disease activity and severity indices were observed (r = 0.29-0.50). The relative risk for severe disease in SLE patients with VH4-34 antibody level in the highest tertile compared to the lowest tertile was 5.25. Twenty-five of 29 patients with lupus nephritis and 6 of 6 patients with central nervous system (CNS) lupus had elevated VH4-34 Ab. Conclusion. With a specificity of 94-95%, the VH4-34 antibody assay may prove valuable as a confirmatory diagnostic test for SLE. In patients with known SLE, serum VH4-34 Ab levels correlate with overall disease severity and activity, but not damage, and with nephritis and CNS lupus.

AB - Objective. To determine the clinical significance of elevated serum levels of VH4-34 encoded antibodies (VH4-34 Ab) with respect to the diagnosis and clinical characteristics of systemic lupus erythematosus (SLE). Methods. Ninety-five patients with SLE and 344 controls were studied. The controls included 34 healthy individuals, 282 patients with nonautoimmune diseases, and 28 patients with autoimmune diseases other than SLE. VH4-34 Ab levels were measured by inhibition ELISA using anti-idiotope monoclonal antibody (9G4). SLE disease activity, severity, and damage were assessed by visual analog scales, Systemic Lupus Activity Measure, Lupus Severity of Disease Index, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. Results. Fifty-two of 95 patients with SLE had elevated levels of VH4-34 Ab compared to 18 of 344 controls (5%), giving a sensitivity of 55% and a specificity of 95% for elevated VH4-34 Ab as a serologic test for SLE. The positive predictive value of elevated VH4-34 under these conditions was 7485%. In this study, anti-dsDNA was not VH4-34 encoded. Significant correlations between VH4-34 and disease activity and severity indices were observed (r = 0.29-0.50). The relative risk for severe disease in SLE patients with VH4-34 antibody level in the highest tertile compared to the lowest tertile was 5.25. Twenty-five of 29 patients with lupus nephritis and 6 of 6 patients with central nervous system (CNS) lupus had elevated VH4-34 Ab. Conclusion. With a specificity of 94-95%, the VH4-34 antibody assay may prove valuable as a confirmatory diagnostic test for SLE. In patients with known SLE, serum VH4-34 Ab levels correlate with overall disease severity and activity, but not damage, and with nephritis and CNS lupus.

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Van Vollenhoven RF, Bieber MM, Powell MJ, Gupta PK, Bhat NM, Richards KL et al. VH4-34 encoded antibodies in systemic lupus erythematosus: A specific diagnostic marker that correlates with clinical disease characteristics. Journal of Rheumatology. 1999 Aug 15;26(8):1727-1733.