Monocyte chemoattractant protein 1 is a prognostic marker in ANCA-associated small vessel vasculitis.
BACKGROUND
The (anti neutrophil cytoplasmatic autoantibody ANCA), associated small vessel vasculitides (ASVV) are relapsing-remitting inflammatory disorders, involving various organs, such as the kidneys. (Monocyte chemoattractant protein 1 MCP-1) has been shown to be locally up regulated in glomerulonephritis and recent studies have pointed out MCP-1 as a promising marker of renal inflammation. Here we measure urinary cytokine levels in different phases of disease, exploring the possible prognostic value of MCP-1, together with (interleukin 6 IL-6), (interleukin 8 IL-8) and (immunoglobulin M IgM).


METHODS
MCP-1, IL-6 and IL-8 were measured using commercially available ELISA kits, whereas IgM in the urine was measured by an in-house ELISA.


RESULTS
The MCP-1 levels in urine were significantly higher in patients in stable phase of the disease, compared with healthy controls. Patients in stable phase, with subsequent adverse events; had significantly higher MCP-1 values than patients who did not. MCP-1 and IgM both tended to be higher in patients relapsing within three months, an observation, however, not reaching statistical significance. Urinary levels of IL-6 correlated with relapse tendency, and IL-8 was associated with disease outcome.


CONCLUSIONS
Patients with ASVV have raised cytokine levels in the urine compared to healthy controls, even during remission. Raised MCP-1 levels are associated with poor prognosis and possibly also with relapse tendency. The association with poor prognosis was stronger for U-MCP-1 than for conventional markers of disease like CRP, BVAS, and ANCA, as well as compared to candidate markers like U-IgM and U-IL-8. We thus consider U-MCP-1 to have promising potential as a prognostic marker in ASVV.
Ohlsson
Sophie
S
Department of Nephrology, Lund University Hospital, Institute for Clinical Sciences, 221 85, Lund, Sweden.
Bakoush
Omran
O
Tencer
Jan
J
Torffvit
Ole
O
Segelmark
Mårten
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism*; D018932:Chemokine CCL2 / Q000097:blood* / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000652:urine; D016209:Interleukin-8 / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D014657:Vasculitis / Q000097:blood* / Q000473:pathology / Q000652:urine*; D055815:Young Adult
D019268:Antibodies, Antineutrophil Cytoplasmic; D018932:Chemokine CCL2; D015850:Interleukin-6; D016209:Interleukin-8