title: Antineutrophil cytoplasm autoantibodies in patients with tuberculosis are directed against bactericidal/permeability increasing protein and are detected after treatment initiation.
abstract: OBJECTIVE
  To determine the prevalence of antineutrophil cytoplasm autoantibodies (ANCA) and its antigenic specificities in sera of patients with pulmonary tuberculosis (Tb) before and after treatment.
  
  
  METHODS
  Sixty-eight patients with culture-proven Tb were studied for the presence of ANCA, both by indirect immunofluorescence (IIF) and ELISA against proteinase-3 (PR3), myeloperoxidase (MPO) and bactericidal/permeability increasing protein (BPI). They were sought before treatment and in 52 of them also after therapy for the infection. High sensitivity C-reactive protein (CRP) was also measured at both times.
  
  
  RESULTS
  ANCA by IIF were found in 3/68 (4.4%) sera prior to treatment, one C-ANCA and two P-ANCA, all recognizing BPI. After treatment, this increased to 15/52 (28.8%), 3 C-ANCA and 12 P-ANCA, the majority directed against BPI (11/15, 73%). BPI-ANCA were positive in 6/68 (8.8%) and 15/52 (28.8%) before and after Tb after treatment initiation (p=0.003). PR3-ANCA and MPO-ANCA were negative in all Tb sera. A positive ANCA test correlated with CRP as inflammatory marker (p=0.001).
  
  
  CONCLUSIONS
  The prevalence of ANCA in culture positive Tb patients is modified by Tb chemotherapy. BPI is the main target antigen for ANCA in tuberculosis and BPI-ANCA increase after treatment.
authors.affiliation: Services of Rheumatology, Hospital Universitario 'Dr. Jose Eleuterio González' of the Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico. jesquive@yahoo.com
authors.forename: Jorge Antonio
authors.initials: JA
authors.lastname: Esquivel-Valerio
authors.forename: Luis Felipe
authors.initials: LF
authors.lastname: Flores-Suárez
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Rodríguez-Amado
authors.forename: Mario Alberto
authors.initials: MA
authors.lastname: Garza-Elizondo
authors.forename: Adrián
authors.initials: A
authors.lastname: Rendón
authors.forename: Mario Cesar
authors.initials: MC
authors.lastname: Salinas-Carmona
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D023181:Antimicrobial Cationic Peptides / Q000276:immunology*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001798:Blood Proteins / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D000939:Epitopes; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D008875:Middle Aged; D053146:Myeloblastin / Q000276:immunology; D009195:Peroxidase / Q000276:immunology; D016036:Seroepidemiologic Studies; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D023181:Antimicrobial Cationic Peptides; D000995:Antitubercular Agents; D001798:Blood Proteins; D000939:Epitopes; C021623:bactericidal permeability increasing protein; D009195:Peroxidase; D053146:Myeloblastin