title: Anti-neutrophil cytoplasmic autoantibodies in patients with symptomatic HIV infection.
abstract: Antibodies against cytoplasmic antigens of neutrophils, producing perinuclear (p-ANCA) as well as cytoplasmic staining with central accentuation (c-ANCA), have been described in non-HIV-infected patients with specific pathology such as glomerulonephritis and vasculitis. Here, we report on a patient with a vasculitis-like syndrome and a positive ANCA-test who appeared to be infected by HIV. Further analysis revealed that ANCA, p-ANCA as well as c-ANCA without central accentuation can be demonstrated in the serum of HIV+ individuals. In a cross-sectional study on individuals in different stages of HIV infection, we found that the occurrence of ANCA was limited to the symptomatic stages of HIV infection: p-ANCA was found in one out of 10 ARC patients and in two out of 11 AIDS patients with malignancies (AIDS-MAL), but not in AIDS patients with opportunistic infections (AIDS-OI). c-ANCA was found in four of the ARC patients, in two of the 14 AIDS-OI patients and in two AIDS-MAL patients. The presence of ANCA was not related to the degree of hypergammaglobulinaemia nor to specific symptomatology. ANCA containing sera from HIV+ individuals did not react with HEp2 cells nor with cytoplasmic antigens of lymphocytes, natural killer (NK) cells or eosinophils. Five out of the 11 (two p-ANCA and three c-ANCA) sera reacted weakly with cytoplasmic antigens of monocytes. All sera reacted with karyoplasts but not with cytoplasts prepared from neutrophils. These results suggest that HIV-ANCA might be directed against myeloid cell-specific granule constituents. However, sandwich-ELISAs with MoAbs against granule antigens that are frequently the target antigens of ANCA in HIV- individuals were negative. Also immunoprecipitation and immunoblotting, using lysates of neutrophil granules, did not allow further identification of the target antigens of HIV-ANCA.
authors.affiliation: Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Amsterdam.
authors.forename: R J
authors.initials: RJ
authors.lastname: Klaassen
authors.forename: R
authors.initials: R
authors.lastname: Goldschmeding
authors.forename: K M
authors.initials: KM
authors.lastname: Dolman
authors.forename: A B
authors.initials: AB
authors.lastname: Vlekke
authors.forename: H M
authors.initials: HM
authors.lastname: Weigel
authors.forename: J K
authors.initials: JK
authors.lastname: Eeftinck Schattenkerk
authors.forename: J W
authors.initials: JW
authors.lastname: Mulder
authors.forename: M L
authors.initials: ML
authors.lastname: Westedt
authors.forename: A E
authors.initials: AE
authors.lastname: von dem Borne
mesh_terms: D000386:AIDS-Related Complex / Q000276:immunology*; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000032:analysis*; D003593:Cytoplasm / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015151:Immunoblotting; D007074:Immunoglobulin G / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D011233:Precipitin Tests
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D007074:Immunoglobulin G