Abstract
Objectives
Anti-neutrophil cytoplasmic autoantibodies (ANCA) are useful diagnostic markers in systemic vasculitic disorders with small-vessel involvement, but depending on the particular test used, the myeloperoxidase (MPO)-ANCA results are variable. In the present study, we performed a comparative analysis between our originally developed nMPO-ANCA assay that targets the native MPO antigen and other commercially available assays using sera of patients with clinical features of ANCA-associated vasculitis (AAV).
Methods
Sera of 24 patients strongly suspected of having AAV were examined for the presence of MPO-ANCAs by our nMPO-ANCA assay and by other commercial-based MPO-ANCA assays. These results were correlated to indirect immunofluorescence microscopy staining patterns and patient clinical parameters.
Results
Eighteen out of 24 patients (75 %) were positive for nMPO-ANCA, compared with 13 out of 24 patients (54 %) by one of the most frequently used commercial-based MPO-ANCA enzyme-linked immunosorbent assays (ELISAs) in Japan. Interestingly, the patients who tested positive with our nMPO-ANCA assay alone showed clinical features of AAV marked by continuous fever, polyarthritis, and mild nephritis. The titers of nMPO-ANCA decreased in association with clinical improvement after treatment.
Conclusions
Our data suggest that a positive nMPO-ANCA result, which identifies antibodies to human native MPO antigen, correlates with AAV disease activity. Moreover, the nMPO-ANCA test has clinical utility in detecting AAV-affected patients who have tested negative using commercially available assays.
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Acknowledgments
We thank Dr. Akiko Okawara for helpful measurements of nMPO-ANCA at National Institute of Infectious Disease, Japan. This study was supported by a grant from Research on Health Sciences focusing on Drug Innovation, the Japan Health Sciences Foundation, the Ministry of Health, Labor, and Welfare of Japan from 2004 to 2007.
Conflict of interest
P.Y.S. is currently employed by UCB Japan Co, Ltd. All other authors have declared no conflicts of interest.
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Yamanishi, Y., Ito-Ihara, T., Nagao, T. et al. Clinical features of patients with anti-neutrophil cytoplasmic autoantibodies targeting native myeloperoxidase antigen. Mod Rheumatol 23, 963–971 (2013). https://doi.org/10.1007/s10165-012-0781-z
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DOI: https://doi.org/10.1007/s10165-012-0781-z