{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:54:33Z","timestamp":1782514473838,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,25]],"date-time":"2019-11-25T00:00:00Z","timestamp":1574640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"Objective<\/jats:title>To evaluate the frequency of cell\u2010bound complement activation products (CB<\/jats:styled-content>\u2010CAP<\/jats:styled-content>s) as a marker of complement activation in patients with suspected systemic lupus erythematosus (SLE<\/jats:styled-content>) and the usefulness of this biomarker as a predictor of the evolution of probable SLE<\/jats:styled-content> into SLE<\/jats:styled-content> as classified by the American College of Rheumatology (ACR<\/jats:styled-content>) criteria.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients in whom SLE<\/jats:styled-content> was suspected by lupus experts and who fulfilled 3 ACR<\/jats:styled-content> classification criteria for SLE<\/jats:styled-content> (probable SLE<\/jats:styled-content>) were enrolled, along with patients with established SLE<\/jats:styled-content> as classified by both the ACR<\/jats:styled-content> and the Systemic Lupus International Collaborating Clinics (SLICC<\/jats:styled-content>) criteria, patients with primary Sj\u00f6gren's syndrome (SS<\/jats:styled-content>), and patients with other rheumatic diseases. Individual CB<\/jats:styled-content>\u2010CAP<\/jats:styled-content>s were measured by flow cytometry, and positivity rates were compared to those of commonly assessed biomarkers, including serum complement proteins (C3 and C4) and autoantibodies. The frequency of a positive multianalyte assay panel (MAP<\/jats:styled-content>), which includes CB<\/jats:styled-content>\u2010CAP<\/jats:styled-content>s, was also evaluated. Probable SLE<\/jats:styled-content> cases were followed up prospectively.<\/jats:p><\/jats:sec>Results<\/jats:title>The 92 patients with probable SLE<\/jats:styled-content> were diagnosed more recently than the 53 patients with established SLE<\/jats:styled-content>, and their use of antirheumatic medications was lower. At the enrollment visit, more patients with probable SLE<\/jats:styled-content> were positive for CB<\/jats:styled-content>\u2010CAP<\/jats:styled-content>s (28%) or MAP<\/jats:styled-content> (40%) than had low complement levels (9%) (P<\/jats:italic> = 0.0001 for each). In probable SLE<\/jats:styled-content>, MAP<\/jats:styled-content> scores of >0.8 at enrollment predicted fulfillment of a fourth ACR<\/jats:styled-content> criterion within 18 months (hazard ratio 3.11, P<\/jats:italic> < 0.01).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Complement activation occurs in some patients with probable SLE<\/jats:styled-content> and can be detected with higher frequency by evaluating CB<\/jats:styled-content>\u2010CAP<\/jats:styled-content>s and MAP<\/jats:styled-content> than by assessing traditional serum complement protein levels. A MAP<\/jats:styled-content> score above 0.8 predicts transition to classifiable SLE<\/jats:styled-content> according to ACR<\/jats:styled-content> criteria.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41093","type":"journal-article","created":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T08:53:27Z","timestamp":1567155207000},"page":"78-88","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Complement Activation in Patients With Probable Systemic Lupus Erythematosus and Ability to Predict Progression to American College of Rheumatology\u2013Classified Systemic Lupus Erythematosus"],"prefix":"10.1002","volume":"72","author":[{"given":"Rosalind","family":"Ramsey\u2010Goldman","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Vezza","family":"Alexander","sequence":"additional","affiliation":[{"name":"Exagen, Inc. Vista California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena M.","family":"Massarotti","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Cedars Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Narain","sequence":"additional","affiliation":[{"name":"Northwell Health and Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell Hempstead New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9546-1664","authenticated-orcid":false,"given":"Cristina","family":"Arriens","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Collins","sequence":"additional","affiliation":[{"name":"MedStar Washington Hospital Center Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Saxena","sequence":"additional","affiliation":[{"name":"New York University School of Medicine New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaim","family":"Putterman","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine and Montefiore Medical Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth C.","family":"Kalunian","sequence":"additional","affiliation":[{"name":"University of California San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Exagen, Inc. Vista California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Dervieux","sequence":"additional","affiliation":[{"name":"Exagen, Inc. Vista California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7248-6623","authenticated-orcid":false,"given":"Arthur","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Exagen, Inc., Vista, California, and Georgetown University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2017-000236"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34473"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780251101"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40930"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)90613-7"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34669"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2014-000056"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2014.07.004"},{"key":"e_1_2_8_11_1","first-page":"213","article-title":"Defining unclassifiable connective tissue diseases: incomplete, undifferentiated, or both? [editorial]","volume":"32","author":"Doria A","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2010.08.014"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23201"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22484"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-205171"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203315625119"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051135"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21591"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2015-000127"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2017.04.001"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2217\/bmm-2017-0371"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38239"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20548"},{"key":"e_1_2_8_25_1","first-page":"313","article-title":"Five\u2010year follow\u2010up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD)","volume":"21","author":"Bodolay E","year":"2003","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1136\/annrheumdis-2017-212599","article-title":"Assay variation in the detection of antinuclear antibodies in the sera of patients with established SLE","volume":"77","author":"Pisetsky DS","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2017.74"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jim.2016.03.001"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2011.22067"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22583"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2013.103"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316671814"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40674"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0521-9"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23196"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1191\/096120300678828073"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203307078579"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2016-000176"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2018-000263"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40747"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.2217\/ijr.12.64"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316635287"}],"container-title":["Arthritis & Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.41093","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/art.41093","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.41093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:48:44Z","timestamp":1759945724000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.41093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,25]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/art.41093"],"URL":"https:\/\/doi.org\/10.1002\/art.41093","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,25]]},"assertion":[{"value":"2019-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}