Frequency Of Antineutrophil Cytoplasmic Antibodies Research Articles

Frequency of anti-neutrophil cytoplasmic antibodies in patients with systemic lupus erythematosus

IntroductionSystemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Patients with SLE exhibit multiple serum autoantibodies, including anti-neutrophil cytoplasmic antibodies (ANCAs). There are two main techniques to detect ANCAs: indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA). In this study, an attempt was made to determine the frequency and clinical associations of ANCAs in patients with SLE. MethodsA cross-sectional study was conducted in a tertiary care hospital in Colombia that included 74 patients with SLE. The presence of ANCAs was assessed using IIF with ethanol-fixed slides, and ELISA was used to detect antibody specificities for myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA. ResultsOf the 74 patients with SLE evaluated, 60 (81.1%) of them were ANCA-positive by IIF. By contrast, only one patient showed specificity for PR3-ANCA by ELISA. The relevance of ANCA positivity by IIF and clinical and serological features was significant for renal involvement (p=.0174), and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (p=.0308). ConclusionANCAs are common in the serum of patients with SLE, as detected by ethanol-fixed slides with IIF staining. However, detection of specificity to PR3 and/or MPO is rare, thus highlighting the importance of detecting these autoantibodies by different techniques.

Frequency of anti-neutrophil cytoplasmic antibodies in patients with systemic lupus erythematosus

IntroductionSystemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Patients with SLE exhibit multiple serum autoantibodies, including anti-neutrophil cytoplasmic antibodies (ANCAs). There are two main techniques to detect ANCAs: indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA). In this study, an attempt was made to determine the frequency and clinical associations of ANCAs in patients with SLE. MethodsA cross-sectional study was conducted in a tertiary care hospital in Colombia that included 74 patients with SLE. The presence of ANCAs was assessed using IIF with ethanol-fixed slides, and ELISA was used to detect antibody specificities for myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA. ResultsOf the 74 patients with SLE evaluated, 60 (81.1%) of them were ANCA-positive by IIF. By contrast, only one patient showed specificity for PR3-ANCA by ELISA. The relevance of ANCA positivity by IIF and clinical and serological features was significant for renal involvement (p=.0174), and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (p=.0308). ConclusionANCAs are common in the serum of patients with SLE, as detected by ethanol-fixed slides with IIF staining. However, detection of specificity to PR3 and/or MPO is rare, thus highlighting the importance of detecting these autoantibodies by different techniques.

Antineutrophil cytoplasmic antibodies in patients treated with methimazole: a prospective Brazilian study

IntroductionThe side effects of antithyroid drugs are well known. Antineutrophil cytoplasmic antibody-associated vasculitis is a severe adverse reaction. Most studies evaluating antineutrophil cytoplasmic antibodies related to antithyroid drugs have been carried out with patients treated with propylthiouracil, but less information is available for methimazole. Furthermore, most studies that investigated antineutrophil cytoplasmic antibodies related to antithyroid drugs were conducted on Asian populations. ObjectiveTo evaluate the frequency of antineutrophil cytoplasmic antibodies and antineutrophil cytoplasmic antibodies-positive vasculitis in an adult population of Brazilian patients treated with methimazole. MethodsThis was a prospective study. We evaluated patients ≥18 years with Graves’ disease who have been using methimazole for at least 6 months (Group A, n=36); with Grave's disease who had been previously treated with methimazole but no longer used this medication for at least 6 months (Group B, n=33), and with nodular disease who have been using methimazole for at least 6 months (Group C, n=13). ResultsANCA were detected in 17 patients (20.7%). Four patients (4.9%) had a strong antineutrophil cytoplasmic antibodies-positive test. The frequency of antineutrophil cytoplasmic antibodies was similar in the groups. When Groups A and B were pooled and compared to Group C to evaluate the influence of Grave's disease, and when Groups A and C were pooled and compared to Group B to evaluate the influence of methimazole discontinuation, no difference was found in the frequency of antineutrophil cytoplasmic antibodies. No difference was observed in sex, age, etiology of hyperthyroidism, anti-TSH receptor antibodies, dose or time of methimazole use between patients with versus without antineutrophil cytoplasmic antibodies. The titers of these antibodies were not correlated with the dose or time of methimazole use. None of the antineutrophil cytoplasmic antibodies-positive patient had clinical event that could potentially result from vasculitis. ConclusionThis clinical study of a Brazilian population shows a considerable frequency of antineutrophil cytoplasmic antibodies in patients treated with methimazole but the clinical repercussion of these findings remains undefined.

Frequency of Antineutrophil Cytoplasmic Antibodies (ANCA) in Some Autoimmune Diseases

Anti-Neutrophil Cytoplasmic Antibodies (ANCA) are a heterogeneous group of autoantibodies with a broad spectrum of clinically associated diseases. The diagnostic value is established for Proteinase 3 (PR3)-ANCA as well as Myeloperoxidase (MPO)-ANCA. To estimate the frequency of anti-neutrophile cytoplasmic antibodies (ANCA) in sera from a group of Iraqi patients with some autoimmune diseases compared with a healthy control group. Serum samples were collected from one hundred patient, 47 males and 53 females; with age range of 16-70 years; 20 specimens from patients with systemic lupus erythematosus (SLE), 30 from patients with ulcerative colitis (UC), and 50 from patients with rheumatoid arthritis (RA). A group of 40 apparently healthy blood donors was included as controls. ANCA were checked using enzyme-linked immunosorbent assay (ELISA). Positive ANCA was detected in sera of 18 (18%) patients with autoimmune disorders. Anti-PR3 was detected in 6 (12%) patients with RA, and in 4(13.4%) patients with UC. Anti-MPO was detected in 3(6%) patients with RA and in 5(16.6%) patients with UC. All serum samples of patients with SLE showed negative ANCA. There were no ANCAs detected in sera from healthy individuals. Mean of serum anti-PR3 (U/ml) among the studied groups was 2.057 in RA, 2.209 in SLE, and 2.283 in UC, and 1.739 in control group. Statistical analysis revealed that differences in the anti-PR3 between RA, UC and controls were highly significant (P > 0.01), whereas just significant with SLE (P> 0.05). Mean of serum of anti-MPO (U/ml) among the studied groups was 0.711 in RA, 0.695 in SLE, and 1.170 in UC, and 0.652 in control group. Statistical analysis revealed that the differences in the anti-MPO between RA and SLE, controls were non significant (P < 0.05), whereas highly significance with UC (P> 0.01).It was concluded that ANCA markers might play a role in the inflammatory process and they are important factors for the clinical course, and prognosis in the patients with autoimmunity. However, ANCA in autoimmune disorders must be interpreted cautiously with particular attention paid to laboratory technique, the size, age and genetic background of the populations studied.
 Key words: Rheumatoid Arthritis, Systemic Lupus Erythematosus, Ulcerative Colitis, Anti-neutrophile Cytoplasmic Antibodies (ANCA).

Brief Report: Prevalence of Antineutrophil Cytoplasmic Antibodies in Infective Endocarditis

Infective endocarditis (IE) mimics primary systemic vasculitis, and there are sporadic reports of positivity for antineutrophil cytoplasmic antibodies (ANCAs) among patients with IE. Because the frequency of ANCAs in IE is unknown, this study was undertaken to assess the seroprevalence of ANCAs in a large number of patients with IE. The study was conducted in the framework of a single-center prospective cohort study of incident IE cases. Demographic, clinical, laboratory, and microbiologic data were collected, and magnetic resonance imaging of the brain was performed at diagnosis. For those patients whose serum had been stored at diagnosis, ANCAs were assessed by indirect immunofluorescence assay in ethanol-, formalin-, and methanol-fixed neutrophils. In addition, ANCA specificity for proteinase 3 (PR3) and myeloperoxidase (MPO) was assessed by enzyme-linked immunosorbent assay. Rheumatoid factor (RF), antinuclear antibodies (ANAs), anticardiolipin antibodies (aCL), and serum Ig levels were also measured. Comparisons between groups were made using Wilcoxon's rank sum and chi-square or Fisher's exact tests. Among 109 patients with IE, 18% had cytoplasmic ANCAs (cANCA) and/or perinuclear ANCAs (pANCA) and 8% had PR3-ANCAs or MPO-ANCAs, some with very high titers. Positivity for both cANCA or pANCA and PR3-ANCAs or MPO-ANCAs was found in 6% of patients, and RF, ANAs, and aCL were detected in 35%, 16%, and 23% of samples, respectively. No consistent clinical pattern of IE was observed in the anti-PR3/anti-MPO-positive IE patients, whereas positivity for cANCA/pANCA was associated with younger age (P = 0.022), more frequent occurrence of echocardiographic vegetations (P = 0.043), and above-normal serum IgG levels (P = 0.017). ANCAs, including PR3- and MPO-ANCAs, occur in a substantial proportion of patients with IE. The link between cANCA/pANCA and specific features of IE requires further study.

Anticorps anticytoplasme des polynucléaires neutrophiles au cours de la mucoviscidose. Fréquence et signification

Some immune system abnormalities have been reported in cystic fibrosis, particularly the presence of antineutrophil cytoplasmic antibodies (ANCAs). The purpose of this study was to determine the frequency of these antibodies in a population of patients with cystic fibrosis and to assess their relationship with the disease progression. Population and methods. – This retrospective study looked for the presence of these antibodies in sera from 64 patients (30 boys and 34 girls) aged one to 29 years. All patients were followed up within the Cystic Fibrosis Center of the University Hospital of Angers. The serum samples were collected in 2001 during the yearly check-up to evaluate disease status. Results. – Seven of the 64 patients presented the antibodies. Univariate analysis showed that these patients were significantly older and more often chronically infected with Pseudomonas aeruginosa than the other patients. They also scored significantly more poorly on pulmonary radiography and showed significantly higher IgG and CRP. Multivariate analysis revealed that the two following independent factors were associated with the presence of ANCAs: chronic P. aeruginosa infection and high IgG level. Conclusion. – This work confirms the abnormally high frequency of antineutrophil cytoplasmic antibodies in patients with cystic fibrosis. These antibodies were observed in the sickest patients with severe infection status. They reflect the impact of inflammatory processes in the pathogenesis of the disease. Detection of these antibodies might be an indication for intensified treatment of bronchial infections.

Frequency of antineutrophil cytoplasmic antibody in Graves' disease patients treated with methimazole.

Retrospective studies have shown antineutrophil cytoplasmic antibody (ANCA) positivity in patients treated for Graves' hyperthyroidism; ANCA has been attributed to either antithyroid drugs or to the disease itself. The aim of this study was to determine ANCA in Graves' disease patients at diagnosis and after treatment with methimazole and to evaluate the relationship between ANCA and hyperthyroidism evolution. Thirty patients recently diagnosed with Graves' hyperthyroidism were prospectively studied. ANCA were determined by indirect immunofluorescence. ANCA autoantibodies against specific antigens (proteinase 3, myeloperoxidase, bactericidal/permeability-increasing protein (BPI), cathepsin, lysozyme, elastase, and lactoferrin) were detected by ELISA. The median observation period was 22 months. Kaplan-Meier analysis was performed to identify ANCA as an outcome variable. Twenty patients (67%) were ANCA positive before the onset of treatment, and four (19%) remained positive after 1 yr of antithyroid drug treatment. No differences were observed in any clinical or analytical features between patients with or without positive ANCA. Before treatment, BPI-positive patients required radioiodine treatment or presented relapse more rapidly than BPI-negative patients (log-rank test P < 0.0002). Patients with Graves' hyperthyroidism show positive ANCA before medical treatment, which points to a relationship with the autoimmune disease itself. Our results suggest that BPI-positive patients tend to relapse with antithyroid medication.

Association of Antineutrophil Cytoplasmic Antibodies With Resistance to Treatment of Left-Sided Ulcerative Colitis: Results of a Pilot Study

To determine the frequency of antineutrophil cytoplasmic antibodies with perinuclear staining in patients with treatment-resistant left-sided ulcerative colitis. We studied four groups: treatment-resistant left-sided ulcerative colitis, treatment-responsive left-sided ulcerative colitis, ulcerative colitis historical controls, and healthy control subjects. Antineutrophil cytoplasmic antibodies were detected by enzyme-linked immunosorbent assay, and positive results were confirmed by demonstration of a perinuclear staining pattern by indirect immunofluorescence assay. The frequency of perinuclear antineutrophil cytoplasmic antibodies was significantly greater in treatment-resistant left-sided ulcerative colitis (90%) than in treatment-responsive left-sided ulcerative colitis (62%) (P = 0.03) or in ulcerative colitis historical controls (60%). The increased frequency of perinuclear antineutrophil cytoplasmic antibodies in treatment-resistant left-sided ulcerative colitis suggests a possible association between these antibodies and relative resistance to medical therapy in patients with ulcerative colitis.