HIGHER ANTI-HEPARAN SULFATE REACTIVITY DURING SYSTEMIC LUPUS-ERYTHEMATOSUS (SLE) DISEASE EXACERBATIONS WITH RENAL MANIFESTATIONS - A LONG-TERM PROSPECTIVE ANALYSIS

Cross-reactive antibodies against heparan sulphate (HS) have been sugg ested to play a role in initiating renal disease in SLE. Recently, we found that HS-reactivity is mediated by anti-DNA antibodies complexed with DNA and histones. To evaluate the clinical significance of anti-H S reactivity, we studied prospectively a cohort of 72 consecutive SLE patients, of whom 22 experienced 40 exacerbations. In 20 of these exac erbations renal symptoms were present. In these 20 exacerbations signi ficantly higher anti-DNA (median 1:160) and anti-HS (median 1:30) titr es were detected compared with exacerbations without renal manifestati ons (median 1:60 for anti-DNA and negative for anti-HS). There were no correlations with other symptoms of SLE. Anti-HS titres showed a sign ificant correlation with anti-DNA antibody titres (r(s) = 0-57, P < 0. 05). Anti-HS without anti-DNA reactivity was never detected. Some SLE patients showed a high anti-DNA titre without anti-HS reactivity, sugg esting that not all anti-DNA antibodies are able to bind to histone/DN A complexes and thus to exhibit anti-HS reactivity. Our findings indic ate that anti-HS reactivity is correlated with renal disease in SLE.