Anti-Myeloperoxidase Antibodies Associate with Future Proliferative Lupus Nephritis.

IF 1.7 Q4 IMMUNOLOGY
Autoimmune Diseases Pub Date : 2017-01-01 Epub Date: 2017-12-24 DOI:10.1155/2017/1872846
S W Olson, J J Lee, M Poirier, D J Little, L K Prince, T P Baker, J D Edison, K C Abbott
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引用次数: 9

Abstract

Background: The subclinical pathophysiology of proliferative lupus nephritis (PLN) has not been fully elucidated. Myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) is associated with PLN, but prediagnostic levels have not been reported.

Methods: We performed a retrospective case-control Department of Defense Serum Repository (DoDSR) study comparing MPO-ANCA levels in longitudinal prediagnostic serum samples for 23 biopsy confirmed proliferative lupus nephritis (PLN) patients to DoDSR identified age, sex, race, and age of serum matched healthy and SLE without LN disease controls. We also compared the temporal relationship of MPO-ANCA to anti-double stranded DNA antibodies (dsDNAab).

Results: A greater proportion of PLN patients had prediagnostic MPO-ANCA levels above ≥3 U/mL and ≥6 U/mL compared to SLE without LN (91% versus 43%, p < 0.001; 57% versus 5%, p < 0.001, resp.). In subgroup analysis, the MPO-ANCA threshold of ≥3 U/mL was significant at <1 year (88% versus 39%, p = 0.007) and 1-4 years (87% versus 38%, p = 0.009) prior to diagnosis. Statistically significant subclinical MPO-ANCA levels (≥3 U/mL) occurred prior to statistically significant dsDNAab ≥ 3 IU/ml (89% versus 11%, p = 0.003).

Conclusions: Subclinical MPO-ANCA levels could distinguish future PLN from SLE without LN. MPO-ANCA manifests prior to clinical disease and subclinical dsDNAab to suggest that it may contribute directly to PLN pathogenicity.

Abstract Image

Abstract Image

抗髓过氧化物酶抗体与未来的增殖性狼疮肾炎有关。
背景:增殖性狼疮性肾炎(PLN)的亚临床病理生理尚未完全阐明。髓过氧化物酶抗中性粒细胞胞浆抗体(MPO-ANCA)与PLN相关,但诊断前水平未见报道。方法:我们进行了一项回顾性病例对照国防部血清库(DoDSR)研究,比较了23例活检确诊的增生性狼疮肾炎(PLN)患者的纵向诊断前血清样本中的MPO-ANCA水平,与DoDSR确定的年龄、性别、种族和年龄相匹配的健康和无LN疾病对照的SLE患者的血清。我们还比较了MPO-ANCA与抗双链DNA抗体(dsDNAab)的时间关系。结果:与没有LN的SLE相比,PLN患者诊断前MPO-ANCA水平分别高于≥3u /mL和≥6u /mL的比例更高(91%对43%,p < 0.001;57%对5% (p < 0.001)。在亚组分析中,MPO-ANCA阈值≥3u /mL在诊断前1-4年(87%对38%,p = 0.009)具有显著性意义。有统计学意义的亚临床MPO-ANCA水平(≥3u /mL)发生在有统计学意义的dsDNAab≥3iu /mL之前(89%对11%,p = 0.003)。结论:亚临床MPO-ANCA水平可以区分未来的PLN和无LN的SLE。MPO-ANCA表现于临床疾病和亚临床dsDNAab之前,表明它可能直接促进PLN的致病性。
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来源期刊
Autoimmune Diseases
Autoimmune Diseases IMMUNOLOGY-
CiteScore
6.10
自引率
0.00%
发文量
9
审稿时长
17 weeks
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