Abstract
Sulfatides are glycosphingolipids that are associated with coagulation and platelet aggregation. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) activates platelet function and often leads to thrombotic complications. These facts suggest an association between serum sulfatides and AAV. We aimed to clarify the significance of serum sulfatide levels in patients with AAV. We conducted a retrospective, single-center, observational pilot study that included 35 patients who developed AAV and 10 control patients who were candidates for living-donor kidney transplantation. We compared serum sulfatide levels between the control and AAV patients. We analyzed the differences in serum sulfatide levels among four classes (focal, crescentic, mixed, and sclerotic class) of glomerular lesions that were categorized by histopathologic classification of ANCA-associated glomerulonephritis. Serum sulfatide levels in patients with AAV were significantly lower than those in the controls. Serum sulfatide levels were significantly different between the four classes. Additionally, serum sulfatide levels in the crescentic class were significantly lower than those in the other classes. Serum sulfatide levels were significantly correlated with albumin, cholesterol, C-reactive protein, and pentraxin 3. In conclusion, serum sulfatide levels are significantly correlated with inflammation, reflecting crescentic glomerulonephritis, which is an active glomerular lesion in AAV patients.
Highlights
Introduction iationsAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic vasculitis that causes organ injuries, to the kidneys and lungs, making it a life-threatening condition [1,2,3]
The differences in serum sulfatide levels between controls and AAV patients were considered to be a result of serum sulfatide levels because the components of serum sulfatides were similar between controls and AAV patients
Our pilot study indicated the following conclusions: Serum sulfatide levels were significantly lower in patients with AAV than in controls
Summary
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic vasculitis that causes organ injuries, to the kidneys and lungs, making it a life-threatening condition [1,2,3]. Progressive glomerulonephritis caused by necrotizing vasculitis in the glomeruli is one of the important kidney lesions that is often detected in patients who develop AAV, leading to end-stage kidney disease [1,2]. Kidney biopsy is a necessary procedure to evaluate these kidney lesions and the disease activity of AAV [4,5]. It is impossible to perform kidney biopsy in all patients with AAV [6], because some patients are already being treated with anti-coagulant or anti-platelet agents or are elderly and have a poor performance status. Serum ANCA titer and C-reactive protein have been used as Licensee MDPI, Basel, Switzerland
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