Pathogenetic role of anti-vascular endothelial cell antibodies in systemic lupus erythematosus.

In order to study the relationship between vascular endothelial cell (VEC) antigen system and systemic lupus erythematosus (SLE), including lupus nephritis, Terasaki's microcytotoxicity test and indirect immunofluorescence were used to detect anti-VEC antibody. VEC was identified by electron microscopy. Sera of 21 SLE patients and of 100 healthy donors were examined. Among the 21 SLE patients evaluated, 17 had kidney injury and 13 were in active stage SLE. Results showed that anti-VEC antibody was found in 76.2% of 21 SLE patients, while only 1% of the controls were positive (P less than 0.05). This antibody was detected in 84.6% of patients in active stage SLE and in 62.5% of patients in inactive stage (P greater than 0.05). In patients with and without kidney injury, it was detected in 82.4% and 50%, respectively (P greater than 0.05). These data show that anti-VEC antibody does exist in the sera of SLE patients, the presence of which is closely related to SLE onset and is independent of whether the patient is in active stage of SLE or has kidney injury. In summary, our data suggest that anti-VEC antibody may be one of the triggering factors in the vasculitis of SLE. It is proposed that renal VEC may act as a target cell which can be attacked by anti-VEC antibody to constitute an in-situ immune complex formation in the kidney, leading to lupus nephritis.