Autoimmunity to lysosomal enzymes: new clues to vasculitis and glomerulonephritis?
The demonstration of autoantibodies to neutrophil cytoplasmic antigens (ANCA) in (1) systemic vasculitides such as Wegener's granulomatosis, classic polyarteritis nodosa and the Churg Strauss syndrome and (2) idiopathic crescentic glomerulonephritis has placed these disorders within the spectrum of autoimmune diseases. The target antigens have been identified as myeloid lysosomal enzymes that are involved in tissue destruction by neutrophils. Recent data suggest a pathogenetic role for these autoimmune responses. The autoantibodies may activate neutrophils, resulting in extensive tissue necrosis. Alternatively, T-cell-mediated immunity to these positively-charged enzymes that localize to polyanionic basement membranes may, in concert with the presence of autoantibodies, result in glomerulonephritis and vasculitis.
Kallenberg
C G
CG
Dept of Clinical Immunology, University Hospital Groningen, The Netherlands.
Tervaert
J W
JW
van der Woude
F J
FJ
Goldschmeding
R
R
von dem Borne
A E
AE
Weening
J J
JJ
D000818:Animals; D001323:Autoantibodies / Q000276:immunology; D001324:Autoantigens / Q000276:immunology*; D001327:Autoimmune Diseases / Q000276:immunology* / Q000473:pathology; D005921:Glomerulonephritis / Q000276:immunology* / Q000473:pathology; D014890:Granulomatosis with Polyangiitis / Q000276:immunology / Q000473:pathology; D006801:Humans; D007105:Immune Complex Diseases / Q000276:immunology; D008247:Lysosomes / Q000201:enzymology*; D053146:Myeloblastin; D009336:Necrosis; D009504:Neutrophils / Q000201:enzymology / Q000276:immunology; D009195:Peroxidase / Q000276:immunology*; D051381:Rats; D012697:Serine Endopeptidases / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology; D014657:Vasculitis / Q000276:immunology* / Q000473:pathology
D001323:Autoantibodies; D001324:Autoantigens; D009195:Peroxidase; D012697:Serine Endopeptidases; D053146:Myeloblastin