A historical essay on detection of anti-neutrophil cytoplasmic antibodies
|
|
- Caroline Barnett
- 6 years ago
- Views:
Transcription
1 Nephrol Dial Transplant (2015) 30: i8 i13 doi: /ndt/gfv070 NDT Perspectives A historical essay on detection of anti-neutrophil cytoplasmic antibodies Niels Rasmussen 1, Allan Wiik 1 and David R. Jayne 2 1 Department of Autoimmune Serology, Statens Seruminstitut, Copenhagen, Denmark and 2 Medicine, Addenbrooke s Hospital, Cambridge, UK Correspondence and offprint requests to: Niels Rasmussen; nir@ssi.dk ABSTRACT In this essay we describe a number of the known and not so known experiences of the early anti-neutrophil cytoplasmic antibodies (ANCAs) days, explaining why and how we reached consensus on the standard indirect immunofluorescence (IIF) techniques, the naming of the two principal C- and P-ANCA patterns, why we chose to use IIF as the standard technique, how the solid phase assays have developed and where we stand today, the use of ANCA for diagnosis and the importance of using several techniques for that purpose, how ANCA titres are related to disease activity and the clinical impact of this, and finally the implications of ANCA being a natural, polyclonal antibody response against various epitopes in relation to diagnostics and disease patterns. Keywords: ANCA, autoantibodies, biomarkers, crescentic glomerulonephritis, vasculitis THE FIRST OBSERVATIONS The indirect immunofluorescence (IIF) technique for detection of autoantibodies to neutrophil granulocytes was initially used to identify neutrophil-specific antibodies in patients with rheumatoid arthritis and Felty ssyndrome[1]. Some of these antibodies stained the nuclei and perinuclear region of neutrophils and monocytes and were therefore designated granulocyte-specific anti-nuclear antibodies (GS-ANA), but early attempts at demonstrating their antigenic targets were unsuccessful. By use of this technique, antibodies staining cytoplasmic granules of neutrophils (anti-pmn-cytoplasm autoantibodies) in a female patient with crescentic glomerulonephritis were incidentally found in 1973, and this technique was therefore included to screen for autoantibodies in the protocols for the Cattegat Study Group of Wegener s Granulomatosis (CSGWG) in In 1982, an Australian group published a short communication, describing similar anti-neutrophil cytoplasm autoantibodies in eight patients with pauci-immune segmental necrotizing glomerulonephritis [2]. With the subsequent paper from the CSGWG [3] and the ensuing paper by the Dutch- CSGWG collaboration [4] more specifically relating the neutrophil cytoplasmic staining autoantibodies, then called anticytoplasmic antibodies (ACPAs), to Wegener s granulomatosis/ granulomatosis with polyangiitis (Wegener s) (GPA) in 1985, testing for these autoantibodies, termed cytoplasmic staining anti-neutrophil cytoplasmic antibodies (C-ANCAs) in 1989, has become an important diagnostic tool for GPA. C-ANCAs in GPA are produced as a polyclonal response to an as yet unidentified agent or disease process and may belong to any of the immunoglobulin classes, IgG, IgM and IgA, but predominantly IgG in the active disease phases [2, 3]. C-ANCAs are typically present during the initial active disease phase, disappearing during remission (Figure 1) and reappearing at relapse [2 4]. ANCA can be detected not only using neutrophils and monocytes as substrate but also using the leukemic HL-60 cell line [5, 6]. It was originally speculated that Ross River virus could have a causal role for the disease [2],butnoparticularinfectiousagent has ever been shown to cause GPA. There is no cross-reactivity with neutrophil constituents from other species like rodents [2]or more specificallyrats,mice,rabbits,cows,horses,catsorhens[5]. THE IIF ASSAYS FOR ANCA Several IIF techniques have been used for the detection of ANCA, differing in source of neutrophils, purification, application on slides and fixation method. The most prominent The Author Published by Oxford University Press Downloaded from onhttps://academic.oup.com/ndt/article-abstract/30/suppl_1/i8/ behalf of ERA-EDTA. All rights reserved. i8
2 difference turned out to be the agent used for fixing the neutrophils. Using formalin would keep all substances fixed in their native position in the neutrophils, whereas ethanol would allow for some substances to be dissolved and redistributed in or outside the neutrophils. When using ethanol, myeloperoxidase (MPO) dissolves from the primary granules and attaches to the cell nucleus yielding a perinuclear staining pattern [7] like GS- ANA, whereas proteinase3 (PR3) does not and therefore yield a cytoplasmic staining pattern. At the first international workshop on ANCA in 1988, it was agreed to use this method with washed human leucocytes as substrate smeared onto glass slides and fixed with ethanol as a standard procedure for IIF detection of ANCA, as this method had already been fine-tuned for that purpose [8]. The nomenclature for these staining patterns, C-ANCA for the cytoplasmic pattern and P-ANCA for the perinuclear pattern (Figure 2), was agreed on at the second International ANCA Workshop in THE ANCA ANTIGENS MPO was the first ANCA antigen to be identified and reported in 1988 [7] as one of the ANCA antigens yielding a P-ANCA FIGURE 1: The first description of the disappearance of C-ANCA (anti-pmn-aab) titre in a GPA patient brought in complete remission on treatment, presented at the First International Academic Conference in Immunology and Immunopathology as applied to Otology and Rhinology, April 1984 in Utrecht, the Netherlands [3]. IIF pattern. Another P-ANCA antigen was identified as human neutrophil elastase (HNE) [9] and soon after, reports from several groups identified the C-ANCA pattern antigen in GPA as a 29 kda serine protease, PR3 [10 14] in 1989 and These antigens were all located to the primary/azurophilic granules in the cytoplasm of the neutrophils, along with cathepsin-g, bactericidal/permeability increasing protein (BPI), HNE and azurocidin. Lactoferrin is located in the secondary/ specific granules, and like alkaline phosphatase located in the tertiary/secretory granules and plasma membrane both have been implicated as P-ANCA antigens, too. Only PR3-ANCA and MPO-ANCA are important in relation to the small vessel vasculitides. Whereas PR3-ANCA/C-ANCA was identified from the very beginning as a marker for GPA, MPO-ANCA soon turned out to be a marker for microscopic polyangiitis (MPA). The importance of PR3-ANCA and MPO- ANCA as disease markers has recently been emphasized in a genomewide association study of ANCA associated vasculitis, as the most marked associations were differentially related to PR3-ANCA and MPO-ANCA [15]. MPO-ANCA, however, is also found in 30 38% of patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome), primarily in patients with vasculitis symptoms [16], and as discussed below, PR3-ANCA and MPO-ANCA may also be detected in other diseases, although the sub-specificities of these ANCAs may differ from those closely related to GPA and MPA. THE EARLY SOLID PHASE ASSAYS FOR DETECTION OF ANCA The first radioimmunoassay for ANCA detection using neutrophil cytoplasm as antigen was described in 1987 [17], the first enzyme-linked immunosorbent assay (ELISA) using affinity purified antigen for C-ANCA detection was described in 1988 [18] and the first commercially available kit for C-ANCA detection using extract from the primary/azurophil/alpha granules of neutrophils was described in 1990 [19]. At the same time, several other solid phase assays were developed, including direct ELISAs and capture ELISAs (using a mouse-monoclonal catching antibody to present the antigen). Gradually, ELISAs became more specific using purified MPO or PR3 as antigens. NDT PERSPECTIVES FIGURE 2: The IIF staining patterns for C-ANCA (A) and P-ANCA (B) using ethanol fixed neutrophil granulocytes. Downloaded from History of ANCA i9
3 NDT PERSPECTIVES THE EC/BCR STANDARDIZATION OF SOLID PHASE ASSAYS At the second International ANCA Workshop in 1989, it became obvious that the emerging solid phase methodologies created for detecting and quantifying PR3-ANCA and MPO-ANCA gave rise to different results and thus necessitated efforts to standardize ANCA determination [20]. With a grant from the EU/EC in 1990 from the EC/BCR programme, 14 European laboratories participated, using three selected preparations of native human PR3 and one preparation of MPO [21 23] for their assays. These results were compared to results in the IIF. The IIF tests were comparable and after corrections of the solid phase methods, the coefficient of variation was reduced to 20%, concluding that the assays could be used for standardized PR3- and MPO-ANCA testing. ANCA DETECTION FOR DIAGNOSTIC PURPOSES However, it is not only necessary to standardize the ANCA assays but also necessary to secure that the clinical indications for ANCA testing are relevant in order to obtain a pre-test probability high enough to justify the test and in order to evaluate the sensitivity and specificity. The Lancet paper from 1985 showed a diagnostic sensitivity of 93% for active GPA [4]. Here, the sera were selected to make sure that the patients in each group were typical patients. In contrast, the sera for the EC/ BCR diagnostic study [23] were unselected sera obtained from consecutive series of patients retrospectively and prospectively in relation to a specific date. This included referred patients on treatment and patients with a suspected but not histopathology proven disease. The overall sensitivity for all PR3/C-ANCA assays was only 64% for GPA. This illustrates that a gating policy for requesting an ANCA test is necessary, as the diagnostic sensitivity and specificity depend entirely on the GPA population examined and the inflammatory disease control population used for selecting a suitably high specificity. This has complicated comparisons between reports on diagnostic sensitivity and specificity of the many different methodologies described since the end of the 1980s. THE DECISION TO USE IIF AS THE PRIMARY TEST FOR ANCA After the EC/BCR standardization, it became relevant to evaluate how, when and which assays should be used for clinical diagnostic use. At an international consensus meeting in Australia [24], it was decided to use the IIF test as the primary diagnostic screening test, based on the extensive experience with the diagnostic potential of the HEp2-cell assay for ANA screening and classification [25]. In accordance with the EC/ BCR study [23], a positive IIF test should always be followed by a specific MPO- or PR3-ANCA test, and ideally all three should be used in each case. This cluster of results would potentially sort out those P-ANCA-/GS-ANA-positive sera that were relevant for small vessel vasculitis from those that could appear in a number of other connective tissue diseases. ANCADETECTIONINDRUG-INDUCED VASCULITIS, INTESTINAL BOWEL DISEASE AND CYSTIC FIBROSIS P-ANCA patterns and atypical (A-ANCA) patterns have been observed in a variety of other diseases than the systemic small vessel vasculitides. It is well-known that certain drugs given over prolonged periods of time can give rise to development of ANCA-positive vasculitis or lupus-like disease. In 1991, it was demonstrated that MPO-ANCA and NHE-ANCA were associated with hydralazine-induced glomerulonephritis [26], and later ANCA against lactoferrin, ANA [27] and ANCA against cathepsin-g was demonstrated in propylthiouracil-induced vasculitis, producing a picture of a multiple autoantibody response in these diseases. A special form of drug-induced disease with necrotizing inflammation is cocaine-induced midline destructive lesions, which is a differential diagnosis to localized GPA in the midface. This condition is highly correlated to HNE-ANCA with a consistent P-ANCA pattern, even though PR3-ANCA is also observed in about half of the cases [28]. The inflammatory bowel diseases, ulcerative colitis (UC) and Crohn s disease have been reported to be associated with a P-ANCA or A-ANCA pattern since the mid-1990s, but determination of the antigen specificity of these ANCA patterns has been difficult and has caused a number of conflicting results. Just lately, using a chemiluminescence immunoassay, the A-ANCA pattern has been correlated to PR3-ANCA in 31% of UC patients [29] and to 38% of Primary Sclerosing Cholangitispatients[30]. The finding of PR3-ANCA yielding an A-ANCA pattern, however, is discussed but not explained. In cystic fibrosis, the presence of ANCA against BPI is correlated to the severity of pulmonary involvement with vasculitis and is also associated with the load of chronic infection with Psudomonas aeruginosa (PA). These BPI-ANCAs, reflecting inflammation of the airways, are not only of IgG class but frequently also of IgA class. Operations to remove infected and diseased tissue in the form of a lung transplant or extensive image guided sinus surgery significantly reduced the IgG as well as the IgA BPI-ANCA levels [31]. Whether the decrease of the infectious burden and/or the removal of inflamed tissue is the reason for the decrease in BPI levels remains to be shown. The correlation between the load of chronic infection with PA and the presence of BPI-ANCA, however, suggests that the infection somehow triggers ANCA production. The presence of ANCA has been reported in a number of infectious conditions including bacterial endocarditis and HIV. Recently, it has been shown that bacterial DNA motifs may trigger production of PR3-ANCA as well as MPO- ANCA in vitro [32]. As new disease activity in GPA is frequently preceded by a flu-like condition, a transient infection may trigger or contribute to disease activity as well as ANCA production. i10 Downloaded from N. Rasmussen et al.
4 PR3-ANCA AND RELAPSE The RELANCA study [33] planned in 1995 as a part of the first series of randomized controlled trials by the European Vasculitis Study Group (EUVAS) using nine PR3-ANCA commercial solid phase assays in monthly serum samples from the NORAM trial, confirmed the original observations of reappearance of C-ANCA at relapse [2 4], but as already concluded in 1989, a rising titre/value was sensitive but not specific for the development of a relapse [34]. The correlation between a rise in titre and relapse is of interest from a pathogenic point of view, but from a clinical point of view, the relevant window for observing a rapid increase due to clinical relapse may be a few weeks. Decrease and increase due to change in therapy develop more slowly. Detecting a relapse therefore requires a sampling frequency of a few weeks, which is almost never the case in the clinical situation. This probably explains why increases in PR3- ANCA levels were not found to correlate to relapses in the WGET study, using three monthly sampling [35]. Nevertheless, an increase in PR3-ANCA titres may reflect a relapse. It is therefore recommended that increasing titres are used as an alert signal for a possible relapse, but that therapeutic action is taken only if a clinical relapse can be confirmed. So far, MPO-ANCA titre increases have not been linked to a similar risk of relapse, but recent studies of MPO-epitopespecific ANCA indicate that certain epitope specificities are linked to relapse as discussed below. CAN RESULTS OF SOLID PHASE ASSAYS FOR PR3-ANCA BE COMPARED? Although the many solid phase assays for PR3-ANCA have good performances for diagnostic sensitivity and specificity, they have turned out to have different performance patterns, i.e. highly variable correlations of PR3-ANCA values between assays [36, 37]. This can be illustrated by applying the dendrogram method on the changes of PR3-ANCA values from entry to relapse for each patient for each of the nine commercial solid phase assays used in the RELANCA study [33]. The dendrogram method applied on the changes from active disease at entry to active disease at relapse revealed that some assays had similar performance, whereas other assays were completely discordant (Figure 3). As PR3-ANCA are normal human, polyclonal autoantibodies [38], ANCA from different persons must be expected to behave differently in different assays depending on the binding profiles of these assays in relation to distribution of IgG subclasses [39], specificity for the epitopes exposed over time [40] and in relation to disease activity [41], binding to free PR3 complexed to alpha-1-antitrypsin in serum [42] and binding to reverse PR3-ANCA [43]. This means that PR3-ANCA values from one assay cannot necessarily be compared with values from another assay and that values from discordant assays cannot be standardized. The marketing of a PR3-ANCA standard from CDC can therefore only be used to standardize each single assay and secure FIGURE 3: Dendrogram illustrating the concordance/discordance between the performance of nine solid phase assays with the level of the horizontal bars illustrating the concordance of the connected assays, where the level of 1 (height) is good concordance and levels >2 are discordance. constant performance of that assay when new batches of antigen are introduced. The dendrogram results support previous findings that combining results from several PR3-ANCA assays may increase the diagnostic potential of PR3-ANCA detection [44]. A screening of PR3-ANCA assays using the dendrogram method can identify each assay as belonging to a certain cluster of assays, which could be helpful to guide the local clinical laboratory to pick out a relevant panel of assays from the assays available in that region, in order to optimize sensitivity and specificity. EPITOPE SPECIFICITY OF ANCA In 1995, it was demonstrated that at least four different epitopes on PR3 were relevant for PR3-ANCA binding [45]. Since then, several groups have been working on the implications of PR3-ANCA epitope specificity. The major problem is that the relevant PR3 epitopes are conformational, complicating the possibilities to use linear epitopes for meaningful diagnostic purposes and pathogenic studies. Production of chimeric human/mouse PR3 recombinant proteins made way for epitope-mapping of anti-pr3 antibodies in 2004 [46] and in 2010, using a refined construct of their original recombinant proteins, the presence of four major surface epitopes with functional importance in relation to enzymatic activity and disease activity was described [41]. A design of specific PR3- epitope-anca assays was therefore suggested to be of potential clinical interest. In contrast to PR3, some meaningful epitopes on MPO are linear. In 1998, it was reported that five recombinant fragments of human MPO identified with rabbit antibodies could sub-classify MPO-ANCA disease in Japan [47]. These findings have been further confirmed in 2007 [48]. In 2006, the technique of producing chimeric human/ mouse constructs was translated to MPO, but the results suggested that further refinements using shorter fragments of the NDT PERSPECTIVES Downloaded from History of ANCA i11
5 NDT PERSPECTIVES epitopes had to be performed [49]. This was described in 2013, using a highly sensitive epitope excision/mass spectrometry approach, reporting on 5 linear as well as 20 conformational epitopes relevant for MPO-ANCA, some being related to disease activity [50]. These findings make it relevant to consider not only the implications for setting up specific functional PR3- and MPO- ANCA assays, but also the implications for further research in the possible pathogenic role of ANCA. Depending on the functional aspects of the individual epitope-specific autoantibodies, these might differ in capacity to exert the pathogenic functions suggested to be effective according to in vitro and in vivo experiments. ACKNOWLEDGEMENTS The EUVAS organization that grew out from the group of colleagues assembled at the first International ANCA Workshop in Copenhagen in Without the numerous contributions from this mass of talent, none of the selected results mentioned in this review could have been achieved. MSc. Severin Olesen Larsen, Statens Serum Institute, has contributed with the statistical handling of data from the EUVAS Serum Bank using the dendrogram method. CONFLICT OF INTEREST STATEMENT None declared. REFERENCES 1. Wiik A. Granulocyte-specific antinuclear antibodies. Possible significance for the pathogenesis, clinical features and diagnosis of rheumatoid arthritis. Allergy 1980; 35: Davies DJ, Moran JE, Niall JF et al. Segmental necrotizing glomerulonephritis with antineutrophil antibody: possible arbovirus aetiology? Br Med J 1982; 285: Rasmussen N, Wiik A. Autoimmunity in Wegener s granulomatosis. In: Veldman JE, McCabe BF, Huizing EH et al. (eds). Immunobiology, Autoimmunity, Transplantation, in Otorhinolaryngology. Amsterdam: Kugler Publications, 1985: van der Woude FJ, Rasmussen N, Lobatto S et al. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener s granulomatosis. Lancet 1985; i: Rasmussen N, Borregaard N, Wieslander J et al. Alfa-ELISA determination of ANCA and characterization of the ANCA-related antigen. APMIS 1989; 97(Suppl. 6): Charles LA, Falk RJ, Jennette JC. Reactivity of anti-neutrophil cytoplasmic autoantibodies with HL-60 cells. Clin Immunol Immunopathol 1989; 53 (2 Pt 1): Falk RJ, Jennette JC. Anti-neutrophil cytoplasmic autoantibodies with specificity for myeloperoxidase in patients with systemic vasculitis and idiopathic necrotizing and crescentic glomerulonephritis. N Engl J Med 1988; 318: Wiik A. Deliniation of a standard procedure for indirect immunofluorescence detection of ANCA. APMIS 1989; 97(Suppl. 6): Goldschmeding R, Cohen Tervaert JW, van der Schoot CE et al. Autoantibodies against myeloid lysosomal enzymes: a novel class of autoantibodies associated with vasculitic syndromes. Kidney Int 1988; 34: Goldschmeding R, van der Schoot CE, ten Bokkel Huinink D et al. Wegener s granulomatosis autoantibodies identify a novel diisopropylfluorophosphate-binding protein in the lysosomes of normal human neutrophils. J Clin Invest 1989; 84: Niles JL, McCluskey RT, Ahmad MF et al. Wegener s granulomatosis autoantigen is a novel neutrophil serine proteinase. Blood 1989; 74: Lüdemann J, Utecht B, Gross WL. Anti-neutrophil cytoplasm antibodies in Wegener s granulomatosis recognize an elastinolytic enzyme. J Exp Med 1990; 171: Jennette JC, Hoidal JR, Falk RJ. Specificity of anti-neutrophil cytoplasmic autoantibodies for proteinase 3. Blood 1990; 75: Jenne DE, Tschopp J, Lüdemann J et al. Wegener s autoantigen decoded. Nature 1990; 346: Lyons PA, Rayner TF, Trivedi S et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med 2012; 367: Mouthon L, Dunogue B, Guillevin L. Diagnosis and classification of eosinophilic granulomatosis with polyangiitis (formerly named Churg- Strauss syndrome). J Autoimmun 2014; 48 49: Savage CO, Winearls CG, Jones S et al. Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis. Lancet 1987; i: Lüdemann J, Utecht B, Groos WL. Detection and quantitation of antineutrophil cytoplasm antibodies in Wegener s granulomatosis by ELISA using affinity purified antigen. J Immunol Methods 1988; 114: Rasmussen N, Sjolin C, Isaksson B et al. An ELISA for detection of antineutrohpil cytoplasm antibodies (ANCA). J Immunol Meth 1990; 127: Daha MR, Rasmussen N. Presentation of solid phase assays from several laboratories. Neth J Med 1990; 36: Hagen EC, Andrassy K, Csernok E et al. The value of indirect immunofluorescence and solid phase techniques for ANCA detection. A report on the first phase of an international cooperative study on the standardization of ANCA assays. J Immunol Methods 1993; 159: Hagen EC, Andrassy K, Csernok E et al. Development and standardization of solid phase assays for the detection of anti-neutrophil cytoplasmic antibodies (ANCA). A report on the second phase of an international cooperative study on the standardization of ANCA assays. J Immunol Methods 1996; 196: Hagen EC, Daha MR, Hermans J et al. Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. Kidney Int 1998; 53: Savige J, Gillis D, Benson E et al. International consensus statement on testing and reporting of antineutrophil cytoplasmic antibodies (ANCA). Am J Clin Pathol 1999; 111: Wiik AS, Høier-Madsen M, Forslid J et al. Antinuclear antibodies: a contemporary nomenclature using HEp-2 cells. J Autoimmun 2010; 35: Nässberger L, Johansson AC, Björck S et al. Antibodies to neutrophil granulocyte myeloperoxidase and elastase: autoimmune responses in glomerulonephritis due to hydralazine treatment. J Intern Med 1991; 229: Choi HK, Merkel PA, Walker AM et al. Drug-associated antineutrophil cytoplasmic antibody-positive vasculitis: prevalence among patients with high titers of antimyeloperoxidase antibodies. Arthritis Rheum 2000; 43: Wiesner O, Russell KA, Lee AS et al. Antineutrophil cytoplasmic antibodies reacting with human neutrophil elastase as a diagnostic marker for cocaine-induced midline destructive lesions but not autoimmune vasculitis. Arthritis Rheum 2004; 50: Mahler M, Bogdanos DP, Pavlidis P et al. PR3-ANCA: a promising biomarker for ulcerative colitis with extensive disease. Clin Chim Acta 2013; 424: Stinton LM, Bentow C, Mahler M et al. PR3-ANCA: A promising biomarker in Primary Sclerosing Cholangitis (PSC). PLoS One 2014; 9: e Aanaes K, Rasmussen N, Pressler T et al. Extensive endoscopic imageguided sinus surgery decreases BPI-ANCA in patients with cystic fibrosis. Scand J Immunol 2012; 76: i12 Downloaded from N. Rasmussen et al.
6 32. Tadema H, Abdulahad WH, Lepse N et al. Bacterial DNA motifs trigger ANCA production in ANCA-associated vasculitis in remission. Rheumatology (Oxford) 2011; 50: Rasmussen N, Salmela A, Ekstrand A et al. European Vasculitis Study Group (EUVAS). Changes in proteinase 3 anti-neutrophil cytoplasm autoantibody levels in early systemic granulomatosis with polyangiitis (Wegener s) may reflect treatment rather than disease activity. Clin Exp Rheumatol 2013; 31(1 Suppl 75): S38 S Cohen Tervaert JW, Huitema MG, van der Giessen M et al. Wegener s granulomatosis and anti-cytoplasmic antibodies: the Groningen experience. APMIS 1989; 97(Suppl. 6): Finkielman JD, Merkel PA, Schroeder D et al. Antiproteinase 3 antineutrophil cytoplasmic antibodies and disease activity in Wegener granulomatosis. Ann Intern Med 2007; 147: Trevisin M, Neeson P, Savige J. The binding of proteinase 3 antineutrophil cytoplasmic antibodies (PR3-ANCA) varies in different ELISAs. J Clin Pathol 2004; 57: Holle JU, Herrmann K, Gross WL et al. Comparative analysis of different commercial ELISA systems for the detection of anti-neutrophil cytoplasm antibodies in ANCA-associated vasculitides. Clin Exp Rheumatol 2012; 30 (Suppl. 70): S66 S Cui Z, Zhao M, Segelmark M et al. Natural autoantibodies to myeloperoxidase, proteinase 3, and the glomerular basement membrane are present in normal individuals. Kidney Int 2010; 78: Segelmark M, Wieslander J. IgG subclasses of anti-neutrophil cytoplasm autoantibodies (ANCA). Nephrol Dial Transplant 1993; 8: Selga D, Segelmark M, Gunnarsson L et al. Epitope shift of proteinase-3 anti-neutrophil cytoplasmic antibodies in patients with small vessel vasculitis. Clin Exp Immunol 2010; 160: Silva F, Hummel AM, Jenne DE et al. Discrimination and variable impact of ANCA binding to different surface epitopes on proteinase3, the Wegener s autoantigen. J Autoimmun 2010; 35: Dolman KM, Stegeman CA, van de Wiel BA et al. Relevance of classic anti-neutrophil cytoplasmic autoantibody (C-ANCA)-mediated inhibition of proteinase3-a1-antitrypsin complexation to disease activity in Wegener s granulomatosis. Clin Exp Immunol 1993; 93: Pendergraft WF, 3rd, Preston GA, Shah RR et al. Autoimmunity is triggered by cpr-3( ), a protein complementary to human autoantigen proteinase-3. Nat Med 2004; 10: Finkielman JD, Lee AS, Hummel AM et al. ANCA are detectable in nearly all patients with active severe Wegener s granulomatosis. Am J Med 2007; 120: 643.e9 643.e Sommarin Y, Rasmussen N, Wieslander J. Characterization of monoclonal antibodies to proteinase-3 and application in the study of epitopes for classical anti-neutrophil cytoplasm antibodies. Exp Nephrol 1995; 3: Selga D, Segelmark M, Wieslander J et al. Epitope mapping of anti-pr3 antibodies using chimeric human/mouse PR3 recombinant proteins. Clin Exp Immunol 2004; 135: Tomizawa K, Mine E, Fujii A et al. A panel set for epitope analysis of myeloperoxidase (MPO)-specific antineutrophil cytoplasmic antibody MPO- ANCA using recombinant hexamer histidine-tagged MPO deletion mutants. J Clin Immunol 1998; 18: Suzuki K, Kobayashi S, Yamazaki K et al. Analysis of risk epitopes of antineutrophil antibody MPO-ANCA in vasculitis in Japanese population. Microbiol Immunol 2007; 51: Erdbrügger U, Hellmark T, Bunch DO et al. Mapping of myeloperoxidase epitopes recognized by MPO-ANCA using human-mouse MPO chimers. Kidney Int 2006; 69: Roth AJ, Ooi JD, Hess JJ et al. Epitope specificity determines pathogenicity and detectability in ANCA-associated vasculitis. J Clin Invest 2013; 123: Received for publication: ; Accepted in revised form: NDT PERSPECTIVES Downloaded from History of ANCA i13
Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis.
Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Bossuyt X, Cohen Tervaert JW, Arimura Y, Blockmans D, Flores-Suárez LF, Guillevin
More informationEDITORIAL. Issue Seventeen, October Editorial Team. Issue Seventeen. Info link
EDITORIAL, October 2004 Welcome to the Spring 2004 Edition of InfoLink. The feature article in this edition has been written by Dr Rodger Laurent, Head of Department, PaLMS Rheumatology Laboratory. The
More informationAbstract. Immunopathology / ADDENDUM TO CONSENSUS STATEMENT ON TESTING AND REPORTING OF ANCA
Immunopathology / ADDENDUM TO CONSENSUS STATEMENT ON TESTING AND REPORTING OF ANCA Addendum to the International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies Quality
More informationA Dual-Fixed Neutrophil Substrate Improves Interpretation of Antineutrophil Cytoplasmic Antibodies by Indirect Immunofluorescence
AJCP / Original Article A Dual-Fixed Neutrophil Substrate Improves Interpretation of Antineutrophil Cytoplasmic Antibodies by Indirect Immunofluorescence Ming-Wei Lin, MBBS, 1,2 Roger A. Silvestrini, 1
More informationComparative Study of ELISA and Indirect Immunofluorescence for the Detection of Anti-Neutrophil Cytoplasmic Antibodies
IMMUNOPATHOLOGY Comparative Study of ELISA and Indirect Immunofluorescence for the Detection of Anti-Neutrophil Cytoplasmic Antibodies Evaluation of the SCIMEDX/EURO Diagnostica ELISA Assay in a Clinical
More informationMethodological update How and why should we detect ANCA?
Clinical and Experimental Rheumatology 2000; 18: 000-000. Methodological update How and why should we detect ANCA? CASE REPORT M. Segelmark, K. Westman, J. Wieslander 1 Department of Nephrology, University
More informationInternational Consensus Statement on Testing and
I m m u n o p a t h o l o g y / TESTING FOR A N C A S International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA) Key Words: ANCA; Autoantibodies; Glomerulonephritis;
More informationInternational Consensus Statement on Testing and
I m m u n o p a t h o l o g y / TESTING FOR A N C A S International Consensus Statement on Testing and Reporting of Antineutrophil Cytoplasmic Antibodies (ANCA) Judy Savige, MB, PhD, David Gillis, MB,
More informationDiagnostic value of classical and atypical antineutrophil cytoplasmic antibody (ANCA) immunofluorescence patterns
124 Immunopathology Department, ICPMR, Westmead Hospital, NSW 2145, Australia RCWWong R A Silvestrini D A Fulcher E M Benson University Department of Medicine, Austin and Repatriation Medical Centre, Heidelberg,
More informationChapter 2 Animal Models of ANCA-Associated Vasculitides
Chapter 2 Animal Models of ANCA-Associated Vasculitides Domenico Ribatti and Franco Dammacco Abstract Antibodies against neutrophil proteins myeloperoxidase (MPO) and proteinase- 3 (PR3) are responsible
More informationAN OVERVIEW OF ANCA-ASSOCIATED VASCULITIS
GRANULOMATOSIS WITH POLYANGIITIS (GPA), MICROSCOPIC POLYANGIITIS (MPA), and EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS (EGPA) AN OVERVIEW OF ANCA-ASSOCIATED VASCULITIS What is ANCA-associated Vasculitis?
More informationMonitoring Proteinase 3 Antineutrophil Cytoplasmic Antibodies for Detection of Relapses in Small Vessel Vasculitis
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, Sept. 2003, p. 769 774 Vol. 10, No. 5 1071-412X/03/$08.00 0 DOI: 10.1128/CDLI.10.5.769 774.2003 Copyright 2003, American Society for Microbiology. All Rights
More informationA review of immunofluorescent patterns associated with antineutrophil cytoplasmic antibodies (ANCA) and their diverentiation from other antibodies
568 J Clin Pathol 1998;51:568 575 Papers University Medicine, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia J A Savige Biochemistry, St Vincent s Hospital, Fitzroy, Victoria,
More informationVASCULITIS PRODUCT HIGHLIGHTS
VASCULITIS PRODUCT HIGHLIGHTS AESKU.DIAGNOSTICS offers a comprehensive and complete diagnostic portfolio in the field of vasculitis diagnostics. Not only are screening and profiling s available but also
More informationNOVA Lite ANCA (Ethanol) Kit with DAPI For In Vitro Diagnostic Use CLIA Complexity: High
Format to CLSI Standards GP2-A5 (Formerly NCCLS) Vol. 26 No. 12 Issue Date: 09/11/13 NOVA Lite ANCA (Ethanol) 708301 Kit with DAPI For In Vitro Diagnostic Use CLIA Complexity: High Principles of the Procedure
More information4. KIDNEYS AND AUTOIMMUNE DISEASE
How to Cite this article: Kidneys and Autoimmune Disease - ejifcc 20/01 2009 http://www.ifcc.org 4. KIDNEYS AND AUTOIMMUNE DISEASE Maksimiljan Gorenjak 4.1 Autoimmune diseases The human immune system limits
More informationDiagnostic Value of Distinguishing and Reporting Different Perinuclear ANCA (P-ANCA) Immunofluorescence Patterns A Prospective Study
Diagnostic Value of Distinguishing and Reporting Different Perinuclear ANCA (P-ANCA) Immunofluorescence Patterns A Prospective Study CME/SAM Susan B. Perel, MBBS, FRACP, FRCPA, 1,2 Kerri M. Prain, 1 Robert
More informationPR3/MPO-ANCA is as effective as immunofluorescence as a first-line test in AAV screening
PR3/MPO-ANCA is as effective as immunofluorescence as a first-line test in AAV screening Stephen Holding PhD FRCPath Consultant Clinical Scientist Hull & East Yorkshire Hospitals steve.holding@hey.nhs.uk
More informationANCA serology in the diagnosis and management of ANCA-associated renal vasculitis GUIDELINES
NEPHROLOGY 2008; 13, S17 S23 ANCA serology in the diagnosis and management of ANCA-associated renal vasculitis Date written: June 2007 Final submission: October 2007 Author: Grant Luxton, Robyn Langham
More informationUniversity of Groningen
University of Groningen Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis Bossuyt, Xavier; Tervaert, Jan-Willem Cohen; Arimura, Yoshihiro;
More informationSmall Vessel Vasculitis
Banff- Rocky Mountain Barry Kassen, MD, FRCPC,FACP Head, Division of Internal Medicine UBC/VGH/SPH Acting Head, Division of Community Internal Medicine November, 2009 Objectives 1. To understand small
More informationEdition Clinical Background Clinical characteristics of ANCAassociated
Edition 2 2003 Clinical Background Clinical characteristics of ANCAassociated vasculitis Historical Review Serological and pathophysiological aspects of ANCA associated vasculitis a historical review Diagnostics
More informationCitation for published version (APA): Chen, M. (2009). Pathogenetic and clinical aspects of ANCA-associated vasculitis Groningen: s.n.
University of Groningen Pathogenetic and clinical aspects of ANCA-associated vasculitis Chen, Min IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite
More informationTwo types of myeloperoxidase-antineutrophil cytoplasmic autoantibodies with a high affinity and a low affinity in small vessel vasculitis
Two types of myeloperoxidase-antineutrophil cytoplasmic autoantibodies with a high affinity and a low affinity in small vessel vasculitis M. Yoshida, M. Sasaki, I. Nakabayashi, M. Akashi, T. Tomiyasu,
More informationLABORATORY STANDARD IN THE DIAGNOSIS AND THERAPY MONITORING OF AUTOIMMUNE DISEASE: VASCULITIS
LABORATORY STANDARD IN THE DIAGNOSIS AND THERAPY MONITORING OF AUTOIMMUNE DISEASE: VASCULITIS Prof. Branko Malenica, Ph.D. Division of Immunology and Reference Center for Laboratory Immunodiagnosis of
More informationantigens co-expressed on granulocytes as well as other leukocyte populations are most often anti-hla class I antibodies. Antigen system Polymorphism Old terminology Location Antigen frequency in Europeans
More informationReview. New advances in the pathogenesis of ANCA-associated vasculitides
Review New advances in the pathogenesis of ANCA-associated vasculitides M. Chen 1,2, C.G.M. Kallenberg 1 1 Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University
More informationCitation for published version (APA): Chen, M. (2009). Pathogenetic and clinical aspects of ANCA-associated vasculitis Groningen: s.n.
University of Groningen Pathogenetic and clinical aspects of ANCA-associated vasculitis Chen, Min IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite
More informationAssays. New. New. Combinations. Possibilities. Patents: EP , AU
Assays Patents: EP 2362222, AU 2011217190 New Combinations New Possibilities Technology Classical Handling of Autoimmune Diagnostics 2-Step Diagnostics 1 st Screening 2 nd Confirmation Cell based IFA ELISA
More informationanti-neutrophil cytoplasmic antibody, myeloperoxidase, microscopic polyangiitis, cyclophosphamide, corticosteroid
Online publication June 24, 2009 ANCA JMAAV 1 2 ANCA JMAAV MPO-ANCA 18 17 50 J Jpn Coll Angiol, 2009, 49: 53 61 anti-neutrophil cytoplasmic antibody, myeloperoxidase, microscopic polyangiitis, cyclophosphamide,
More informationAnti-Neutrophil Cytoplasmic Auto Antibodies (ANCA) in Pakistani Patients with Systemic Vasculitides
Abstract Anti-Neutrophil Cytoplasmic Auto Antibodies (ANCA) in Pakistani Patients with Systemic Vasculitides Pages with reference to book, From 272 To 275 Tahir A. Ahmed, Iftikhar A. Malik ( Armed Forces
More informationEliA MPO S and EliA PR3 S
Edition 1 2011 n Review ANCA and associated diseases n The Assays EliA MPO S and EliA PR3 S n Experience ANCA testing by high sensitive methods CONTENTS Editorial Some months ago a Swiss colleague sent
More informationLong-term outcomes of patients with propylthiouracil-induced anti-neutrophil cytoplasmic auto-antibody-associated vasculitis
Rheumatology 2008;47:1515 1520 Advance Access publication 1 August 2008 doi:10.1093/rheumatology/ken321 Long-term outcomes of patients with propylthiouracil-induced anti-neutrophil cytoplasmic auto-antibody-associated
More informationAntineutrophil Cytoplasmic Antibodies in Patients with Pulmonary Tuberculosis
SHORT PAPER Antineutrophil Cytoplasmic Antibodies in Patients with Pulmonary Tuberculosis Roya Sherkat*, Kamyar Mostafavizadeh, Lale Zeydabadi, Parisa Shoaei, Sodabeh Rostami Isfahan University of Medical
More informationCase Rep Nephrol Urol 2013;3: DOI: / Published online: January 27, 2013
Published online: January 27, 2013 1664 5510/13/0031 0016$38.00/0 This is an Open Access article licensed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivs 3.0 License (www.karger.com/oa-license),
More informationOlaf Wiesner, 1 Kimberly A. Russell, 1 Augustine S. Lee, 1 Dieter E. Jenne, 2 Matteo Trimarchi, 3 Gina Gregorini, 3 and Ulrich Specks 1
ARTHRITIS & RHEUMATISM Vol. 50, No. 9, September 2004, pp 2954 2965 DOI 10.1002/art.20479 2004, American College of Rheumatology Antineutrophil Cytoplasmic Antibodies Reacting With Human Neutrophil Elastase
More informationAutoimmune diagnostics. A comprehensive product line for the detection of autoantibodies
Autoimmune diagnostics A comprehensive product line for the detection of autoantibodies Autoimmune diagnostics Autoimmune diseases are chronic inflammatory processes with an indeterminate etiology. They
More informationVasculitis of the peripheral nervous system
4 rd Congress of the European Academy of Neurology Lisbon, Portugal, June 16-19, 2018 Teaching Course 5 Acute emergencies in neuromuscular disease - Level 2 Vasculitis of the peripheral nervous system
More informationAnti-neutrophil antibodies in inflammatory bowel
668 Department of Renal Medicine, Institute of Urology, University College and Middlesex School of Medicine, London, WI G Cambridge B Leaker Department of Gastroenterology, The Royal London Hospital, London
More informationCitation for published version (APA): Chen, M. (2009). Pathogenetic and clinical aspects of ANCA-associated vasculitis Groningen: s.n.
University of Groningen Pathogenetic and clinical aspects of ANCA-associated vasculitis Chen, Min IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite
More informationSimultaneous comprehensive multiplex autoantibody analysis by CytoBead technology for Rapidly Progressive Glomerulonephritis.
Simultaneous comprehensive multiplex autoantibody analysis by CytoBead technology for Rapidly Progressive Glomerulonephritis l Assays Indirect Immunofluorescence Goldstandard for Diagnosis of Autoimmune
More informationDiagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis
Kidney International, Vol. 53 (1998), pp. 743 753 Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis E. CHRISTIAAN HAGEN, MOHAMED R. DAHA,
More informationAnnual Rheumatology & Therapeutics Review for Organizations & Societies
Annual Rheumatology & Therapeutics Review for Organizations & Societies Update on Granulomatosis with Polyangiitis (Wegener s) Learning Objectives Identify the clinical features of granulomatosis with
More informationANTI NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) TESTING GUIDELINES
ANTI NEUTROPHIL CYTOPLASMIC ANTIBODY (ANCA) TESTING GUIDELINES Version: 1.0 Ratified by: Clinical Biochemistry Senior Staff Group Date ratified: Name of originator/author: Director responsible for implementation:
More informationANCA associated vasculitis in China
ANCA associated vasculitis in China Min Chen Renal Division, Peking University First Hospital, Beijing 100034, P. R. China 1 General introduction of AAV in China Disease spectrum and ANCA type Clinical
More informationClinical features and outcome of patients with both ANCA and anti-gbm antibodies
Kidney International, Vol. 66 (24), pp. 1535 154 Clinical features and outcome of patients with both ANCA and anti-gbm antibodies JEREMY B. LEVY, TARIG HAMMAD, ANNE COULTHART, TAMMY DOUGAN, and CHARLES
More informationPlasma exchanges in ANCA-associated vasculitis
Plasma exchanges in ANCA-associated vasculitis Xavier Puéchal, MD, PhD Centre de Référence des Maladies auto-immunes systémiques rares d Ile de France Hôpital Cochin Université Paris Descartes http://www.vascularites.org
More informationThe systemic vasculitides were traditionally classified. Treatment of ANCA-associated Systemic Vasculitis. H. Michael Belmont, M.D.
60 Treatment of ANCA-associated Systemic Vasculitis H. Michael Belmont, M.D. Abstract The antineutrophil cytoplasmic antibodies (ANCA)-associated small vessel vasculitides include Wegener s granulomatosis,
More informationDC were seeded into tissue culture dishes in IMDM 2% FCS, and added with PMN. (1:1; PMN: DC) for 16h also in the presence of DNAse (100 U/ml); DC were
Supplementary methods Flow cytometric analysis of DCs. DC were seeded into tissue culture dishes in IMDM 2% FCS, and added with PMN (1:1; PMN: DC) for 16h also in the presence of DNAse (100 U/ml); DC were
More informationClinical audit. An audit of ANCA in routine clinical practice. JDM Edgar, SA McMillan, IN Bruce, SK Conlan. biochemical, radiological, and
Postgrad Med J 1995; 71: 605-612 C The Fellowship of Postgraduate Medicine, 1995 Clinical audit Department of Immunology, Queen's Medical Centre, Nottingham, NG7 2UH, UK JDM Edgar Regional Immunology Laboratory,
More informationUniversity of Groningen. Anca associated vasculitis Boomsma, Maarten Michiel
University of Groningen Anca associated vasculitis Boomsma, Maarten Michiel IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check
More informationImmune complex deposits in ANCA-associated crescentic glomerulonephritis: A study of 126 cases
Kidney International, Vol. 65 (2004), pp. 2145 2152 Immune complex deposits in ANCA-associated crescentic glomerulonephritis: A study of 126 cases MARK HAAS and JOSEPH A. EUSTACE Department of Pathology
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Jones RB, Cohen Tervaert JW, Hauser T, et al. Rituximab versus
More informationThe European and French networks. Christian Pagnoux, MD, MSc, MPH Mount Sinai Hospital, Toronto, Canada Cochin Hospital, Paris, France
The European and French networks Christian Pagnoux, MD, MSc, MPH Mount Sinai Hospital, Toronto, Canada Cochin Hospital, Paris, France French Vasculitis Study Group December 1980: L. Guillevin no research,
More informationAntibodies to selected minor target anti-neutrophil cytoplasmic antigens in systemic lupus patients
Original Article Antibodies to selected minor target anti-neutrophil cytoplasmic antigens in systemic * MBChB, FIBM immunology Fac Med Baghdad 25; Vol.5, No.3 Received:March,25 Accepted: May,25 Introduction:
More informationSHO Teaching. Dr. Amir Bhanji Consultant Nephrologist, Q.A hospital, Portsmouth
SHO Teaching Vasculitis Renal medicine Dr. Amir Bhanji Consultant Nephrologist, Q.A hospital, Portsmouth OUTLINE What is vasculitis Causes Classification Brief look into ANCA Associated Vasculitis (AAV)
More informationImproved prognosis in Norwegian patients with glomerulonephritis associated with anti-neutrophil cytoplasmic antibodies
Nephrol Dial Transplant (2015) 30: i67 i75 doi: 10.1093/ndt/gfv008 Advance Access publication 17 February 2015 Original Article Improved prognosis in Norwegian patients with glomerulonephritis associated
More informationReview Article. Introduction. Abstract. David Sinclair and Judith M Stevens
Review Article Role of antineutrophil cytoplasmic antibodies and glomerular basement membrane antibodies in the diagnosis and monitoring of systemic vasculitides David Sinclair and Judith M Stevens Abstract
More informationMedical Policy Title: Serum Antibodies for ARBenefits Approval: 10/12/11
Medical Policy Title: Serum Antibodies for ARBenefits Approval: 10/12/11 Diagnosis of Inflammatory Bowel Disease Effective Date: 01/01/2012 Document: ARB0314 Revision Date: Code(s): 83516 Immunoassay for
More informationV asculitis is an inflammatory process of blood vessels,
723 ORIGINAL ARTICLE Cinical and pathological characteristics of Chinese patients with antineutrophil cytoplasmic autoantibody associated systemic vasculitides: a study of 426 patients from a single centre
More informationANTINEUTROPHIL CYTOPLASMIC ANTIBODIES IN RHEUMATOID ARTHRITIS PATIENTS
British Journal of Rheumatology 1996;35:38-43 ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES IN RHEUMATOID ARTHRITIS PATIENTS M. DE BANDT, O. MEYER, T. HAIM ind M.-F. KAHN Laboratory of Immuno-Rheumatology, Bichat
More informationRenal transplantation
NEPHROLOGY 2008; 13, S37 S43 doi:10.1111/j.1440-1797.2008.00996.x Renal transplantation Date written: November 2006 Final submission: July 2007 Author: Nigel Toussaint GUIDELINES No recommendations possible
More informationEstimating Renal Survival Using the ANCA-Associated GN Classification
Estimating Renal Survival Using the ANCA-Associated GN Classification Marc Hilhorst, Benjamin Wilde, Peter van Breda Vriesman, Pieter van Paassen, and Jan Willem Cohen Tervaert, for the Limburg Renal Registry
More informationVasculitis (Polyarteritis Nodosa, Microscopic Polyangiitis, Wegener s Granulomatosis, Henoch- Schönlein Purpura)
Vasculitis (Polyarteritis Nodosa, Microscopic Polyangiitis, Wegener s Granulomatosis, Henoch- Schönlein Purpura) J. Charles Jennette Ronald J. Falk The kidneys are affected by a variety of systemic vasculitides
More informationAntineutrophil cytoplasmic antibody (ANCA) associated. Article
Annals of Internal Medicine Article Predictors of Relapse and Treatment Resistance in Antineutrophil Cytoplasmic Antibody Associated Small-Vessel Vasculitis Susan L. Hogan, PhD, MPH; Ronald J. Falk, MD;
More informationANCA-associated vasculitis and organ-on-chips disease model
Vaskulitis-zentrum Süd Tübingen-Kirchheim ANCA-associated vasculitis and organ-on-chips disease model Elena Csernok Klinik für Innere Medizin, Rheumatologie und Immunologie Kreiskliniken Esslingen Klinik
More informationActivation, apoptosis and clearance of neutrophils in Wegener's granulomatosis Rossum, Aart Pieter van
University of Groningen Activation, apoptosis and clearance of neutrophils in Wegener's granulomatosis Rossum, Aart Pieter van IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's
More informationDiagnostic Tests in Rheumatic Disease: What s Old, What s New & What s Useful? COPYRIGHT
Diagnostic Tests in Rheumatic Disease: What s Old, What s New & What s Useful? Robert H. Shmerling, M.D. Beth Israel Deaconess Medical Center Boston, MA Diagnostic Tests in Rheumatic Disease: What's Old,
More informationNIH Public Access Author Manuscript Ann Rheum Dis. Author manuscript; available in PMC 2011 July 19.
NIH Public Access Author Manuscript Published in final edited form as: Ann Rheum Dis. 2009 January ; 68(1): 103 106. doi:10.1136/ard.2008.097758. Comparison of disease activity measures for anti-neutrophil
More informationTell me more about vasculitis. Lisa Willcocks Consultant in Nephrology and Vasculitis, Addenbrooke s Hospital
Tell me more about vasculitis Lisa Willcocks Consultant in Nephrology and Vasculitis, Addenbrooke s Hospital Talk overview Case study ANCA-associated vasculitis What is ANCA vasculitis? What causes ANCA
More informationEnd-stage renal disease in ANCA-associated vasculitis
Nephrol Dial Transplant (2017) 32: 248 253 doi: 10.1093/ndt/gfw046 Advance Access publication 6 April 2016 End-stage renal disease in ANCA-associated vasculitis Sergey Moiseev 1, Pavel Novikov 1, David
More informationRenal outcome of kidney-transplantation in Korean recipients with ANCA-associated vasculitis
Renal outcome of kidney-transplantation in Korean recipients with ANCA-associated vasculitis E.S. Park, S.S. Ahn, S.M. Jung, J.J. Song, Y.-B. Park, S.-W. Lee Division of Rheumatology, Department of Internal
More informationAntineutrophil cytoplasm antibody associated vasculitis: recent developments
mini review http://www.kidney-international.org & 2013 International Society of Nephrology Antineutrophil cytoplasm antibody associated vasculitis: recent developments Shunsuke Furuta 1 and David R.W.
More informationGlucocorticoids and Relapse and Infection Rates in Anti-Neutrophil Cytoplasmic Antibody Disease
Article Glucocorticoids and Relapse and Infection Rates in Anti-Neutrophil Cytoplasmic Antibody Disease JulieAnne G. McGregor, Susan L. Hogan, Yichun Hu, Caroline E. Jennette, Ronald J. Falk, and Patrick
More informationDr Rodney Itaki Lecturer Anatomical Pathology Discipline. University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology
Vasculitis Dr Rodney Itaki Lecturer Anatomical Pathology Discipline University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology Disease Spectrum Hypersensitivity vasculitis/microscopic
More informationPersistent T-cell activation and clinical correlations in patients with ANCA-associated systemic vasculitis
NDT Advance Access published March 26, 2006 Nephrol Dial Transplant (2006) 1 of 8 doi:10.109/ndt/gfl097 Original Article Persistent T-cell activation and clinical correlations in patients with ANCA-associated
More informationThe clinical presentation and therapy of diseases related to anti-neutrophil cytoplasmic antibodies (ANCA)
The clinical presentation and therapy of diseases related to anti-neutrophil cytoplasmic antibodies (ANCA) Maria Weiner and Mårten Segelmark Journal Article Original Publication: N.B.: When citing this
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationMINIREVIEWS. Clinical Utility of Testing for Antineutrophil Cytoplasmic Antibodies
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, Sept. 1999, p. 645 651 Vol. 6, No. 5 1071-412X/99/$04.00 0 Copyright 1999, American Society for Microbiology. All Rights Reserved. MINIREVIEWS Clinical Utility
More informationANCA and associated diseases: immunodiagnostic and pathogenetic aspects
Clin Exp Immunol 1993; 91:1-12 REVIEW ANCA and associated diseases: immunodiagnostic and pathogenetic aspects W. L. GROSS, W. H. SCHMITT & E. CSERNOK Department of Clinical Rheumatology, Medical University
More informationVasculitis. Edward Dwyer, M.D. Division of Rheumatology. Vasculitis
Edward Dwyer, M.D. Division of Rheumatology VASCULITIS is a primary inflammatory disease process of the vasculature Determinants of the Clinical Manifestations of : Target organ involved Size of vessel
More informationInflammatory bowel disease with cytoplasmic-staining. antineutrophil cytoplasmic antibody and extensive colitis.
ORIGINAL ARTICLE Inflammatory bowel disease with cytoplasmic-staining antineutrophil cytoplasmic antibody and extensive colitis Hugh James Freeman MD HJ Freeman. Inflammatory bowel disease with cytoplasmicstaining
More informationAntineutrophil Cytoplasmic Antibodies: Historical perspectives and new advances
INOVA NEWS Antineutrophil Cytoplasmic Antibodies: Historical perspectives and new advances First described in 1982, antineutrophil cytoplasmatic antibodies (ANCA) represent a diagnostically important group
More informationImmunoglobulin levels and infection risk with rituximab induction for anti-neutrophil cytoplasmic antibody-associated vasculitis
Clinical Kidney Journal, 2017, vol. 10, no. 4, 470 474 doi: 10.1093/ckj/sfx014 Advance Access Publication Date: 12 April 2017 Original Article ORIGINAL ARTICLE Immunoglobulin levels and infection risk
More informationHistopathology: Glomerulonephritis and other renal pathology
Histopathology: Glomerulonephritis and other renal pathology These presentations are to help you identify basic histopathological features. They do not contain the additional factual information that you
More informationVasculitis local: systemic
Vasculitis Inflammation of the vessel wall. Signs and symptoms: 1- local: according to the involved tissue 2- systemic:(fever, myalgia, arthralgias, and malaise) Pathogenesis 1- immune-mediated 2- infectious
More informationRituximab treatment for ANCA-associated vasculitis in childhood
Rituximab treatment for ANCA-associated vasculitis in childhood DISCLOSURE I have no relevant financial relationships to disclose Katharine Moore MD Nov 14, 2012 University of Colorado School of Medicine
More informationNew biomarkers for ANCA-associated Vasculitis? Juliana Bordignon Draibe
New biomarkers for ANCA-associated Vasculitis? Juliana Bordignon Draibe Summary Introduction Antibodies: ANCAs, Anti-LAMP-2, Anti-moesin B and T lymphocytes Markers of vascular activation: complement,
More informationCitation for published version (APA): Chen, M. (2009). Pathogenetic and clinical aspects of ANCA-associated vasculitis Groningen: s.n.
University of Groningen Pathogenetic and clinical aspects of ANCA-associated vasculitis Chen, Min IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite
More informationAntiproteinase 3- and antimyeloperoxidase-associated vasculitis.
Kidney International, Vol. 57 (2000), 2195 2206 Antiproteinase 3- and antimyeloperoxidaseassociated vasculitis PERSPECTIVES IN RENAL MEDICINE CASPER F.M. FRANSSEN, COEN A. STEGEMAN, CEES G.M. KALLENBERG,
More informationCirculating complement activation in patients with anti-neutrophil cytoplasmic antibody associated vasculitis
http://www.kidney-international.org & 212 International Society of Nephrology see commentary on page 16 Circulating complement activation in patients with anti-neutrophil cytoplasmic antibody associated
More informationAnti-PR3 and Anti-MPO IgG ANCA in Autistic Children With Chronic GI Disease
Anti-PR3 and Anti-MPO IgG ANCA in Autistic Children With Chronic GI Disease A.J. Russo 1, A Krigsman 2, B Jepson 2 and Andrew Wakefield 2 ORIGINAL RESEARCH 1 Science Department, Mount Saint Mary s University,
More informationCase Report A Case of Concurrent MPO-/PR3-Negative ANCA-Associated Glomerulonephritis and Membranous Glomerulopathy
Case Reports in Nephrology Volume 2015, Article ID 316863, 5 pages http://dx.doi.org/10.1155/2015/316863 Case Report A Case of Concurrent MPO-/PR3-Negative ANCA-Associated Glomerulonephritis and Membranous
More informationRheumatologic Lab Tests
Rheumatologic Lab Tests What the Practitioner Needs to Know Mary Nakamura M.D. 2008 Rheumatologic Lab Tests Are rarely diagnostic of any specific disease If you do not have in mind a rheumatologic disease
More informationClinical Implications and Utility of Antineutrophil Cytoplasmic Antibodies in Rheumatoid Arthritis, Spondylarthropathy and Ulcerative Colitis
Clinical Implications and Utility of Antineutrophil Cytoplasmic Antibodies in Rheumatoid Arthritis, Spondylarthropathy and Ulcerative Colitis Acta Universitatis Tamperensis 753 ANU MUSTILA Clinical Implications
More informationComplement in vasculitis and glomerulonephritis. Andy Rees Clinical Institute of Pathology Medical University of Vienna
Complement in vasculitis and glomerulonephritis Andy Rees Clinical Institute of Pathology Medical University of Vienna 41 st Heidelberg Nephrology Seminar March 2017 The complement system An evolutionary
More informationWegener s Granulomatosis JUN-KI PARK
Wegener s Granulomatosis JUN-KI PARK Definition History Epidemiology Clinical symptoms Pathophysiology Treatment Wegener granulomatosis (WG) is a complex, immunemediated disorder, which along with microscopic
More informationSmall Vessel Vasculitis
Small Vessel Vasculitis Paul A Brogan Professor of Vasculitis and Consultant Paediatric Rheumatologist Department of Rheumatology Institute of Child Health and Great Ormond St Hospital, London UK P.brogan@ucl.ac.uk
More informationVASCULITIS. Case Presentation. Case Presentation
VASCULITIS Case Presentation The patient is a 24 year old woman who presented to the emergency room with left-sided weakness. She was confused and complained of a severe headache. She was noted to have
More informationRepeat protocol renal biopsy in ANCA-associated renal vasculitis
NDT Advance Access published February 26, 2014 Nephrol Dial Transplant (2014) 0: 1 5 doi: 10.1093/ndt/gfu042 Original Article Repeat protocol renal biopsy in ANCA-associated renal vasculitis Zdenka Hruskova
More information