Document Detail


Epitope shift of proteinase-3 anti-neutrophil cytoplasmic antibodies in patients with small vessel vasculitis.
MedLine Citation:
PMID:  20059480     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anti-neutrophil cytoplasmic antibodies against proteinase 3 (PR3-ANCA) are used as diagnostic tools for patients with small vessel vasculitis (AASV). We have produced chimeric mouse/human PR3 molecules and investigate changes in reactivity over time and the possible relationship between epitope specificity and clinical course. Thirty-eight PR3-ANCA-positive patients diagnosed between 1990 and 2003 were followed until December 2005. Plasma was collected at each out-patient visit and older samples were retrieved retrospectively. Patients reacted with multiple epitopes at the time of diagnosis. At subsequent relapses 12 patients shifted reactivity, in 11 cases from epitopes located in the C-terminal towards epitopes in the N-terminal. Patients with reactivity against N-terminal parts of PR3 at diagnosis had a significantly lower relapse rate, 30% compared to 78% in the group with predominantly C-terminal reactivity (P = 0.04). The reactivity pattern did not correlate to outcome measured as death, end-stage renal disease or vasculitis activity index score (VDI) at 5 years. Further research is necessary to conclude if this is a general phenomenon.
Authors:
D Selga; M Segelmark; L Gunnarsson; T Hellmark
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-01-06
Journal Detail:
Title:  Clinical and experimental immunology     Volume:  160     ISSN:  1365-2249     ISO Abbreviation:  Clin. Exp. Immunol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-07-09     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  0057202     Medline TA:  Clin Exp Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  318-24     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Clinical Sciences in Lund, Lund University and Lund University Hospital, Sweden. Daina.Selga@med.lu.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antibodies, Antineutrophil Cytoplasmic / blood,  immunology*
Antibody Specificity / immunology*
Autoimmune Diseases / blood,  immunology*,  mortality,  therapy
Child
Epitopes / immunology*,  metabolism
Female
Humans
Male
Middle Aged
Myeloblastin / immunology*,  metabolism
Prospective Studies
Protein Structure, Tertiary
Retrospective Studies
Vasculitis / blood,  immunology*,  mortality,  therapy
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Epitopes; EC 3.4.21.76/Myeloblastin
Comments/Corrections

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