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Rheumatology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Autoantibodies are a hallmark of lupus nephritis (LN), but their association with LN classes and treatment response are not adequately known. In this study, we quantified circulating autoantibodies in the Accelerating Medicines Partnership LN longitudinal cohort to identify serological biomarkers of LN histologic classification and treatment response and how these biomarkers change over time based on treatment response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Peripheral blood samples were collected from 279 patients with systemic lupus erythematosus undergoing diagnostic kidney biopsy based on proteinuria. Of these, 268 were diagnosed with LN. Thirteen autoantibody specificities were measured by bead\u2010based assays (Bio\u2010Rad Bioplex 2200) and anti\u2010C1q by enzyme\u2010linked immunosorbent assay at the time of biopsy (baseline) and at 3, 6, and 12 months after biopsy. Clinical response was determined at 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Proliferative LN (International Society of Nephrology\/Renal Pathology Society class III\/IV\u00b1V, n = 160) was associated with higher concentrations of anti\u2010C1q, anti\u2010chromatin, anti\u2013double\u2010stranded DNA (dsDNA), and anti\u2013ribosomal P autoantibodies compared to nonproliferative LN (classes I\/II\/V\/VI, n = 108). Anti\u2010C1q and\u2010dsDNA were independently associated with proliferative LN. In proliferative LN, higher baseline anti\u2010C1q levels predicted complete response (area under the curve [AUC] 0.72; <jats:italic>P<\/jats:italic> = 0.002) better than baseline proteinuria (AUC 0.59; <jats:italic>P<\/jats:italic> = 0.21). Furthermore, all autoantibody levels except for anti\u2010La\/SSB decreased over 12 months in patients with proliferative, but not membranous, LN with a complete response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Baseline levels of anti\u2010C1q and anti\u2010dsDNA may serve as noninvasive biomarkers of proliferative LN, and anti\u2010C1q may predict complete response at the time of kidney biopsy. In addition, tracking autoantibodies over time may provide further insights into treatment response and pathogenic mechanisms in patients with proliferative LN.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art42941-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42941","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T05:31:21Z","timestamp":1720071081000},"page":"1611-1622","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Association of Autoantibody Concentrations and Trajectories With Lupus Nephritis Histologic Features and Treatment Response"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6738-4836","authenticated-orcid":false,"given":"Andrea","family":"Fava","sequence":"first","affiliation":[{"name":"Johns Hopkins University  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona A.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla J.","family":"Guthridge","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kheir","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Macwana","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wade","family":"DeJager","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Gross","sequence":"additional","affiliation":[{"name":"Oklahoma Medical Research Foundation  Oklahoma City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Izmirly","sequence":"additional","affiliation":[{"name":"New York University School of Medicine  New York City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-2976","authenticated-orcid":false,"given":"H. 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