Pathogenesis of ANCA-associated vasculitis.
Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) comprises a group of systemic inflammatory vasculitides associated with circulating autoantibodies directed against the neutrophil granule components proteinase 3 and myeloperoxidase. ANCA interact with their target antigens on cytokine primed neutrophils, causing neutrophil activation via several signaling pathways that culminates in endothelial interaction, degranulation, cytokine production, and endothelial and tissue damage. The presence of autoantibodies implies the assistance of autoreactive T-helper cells and B cells, and a failure of regulatory mechanisms. This article reviews the current evidence for the pathogenic mechanisms culminating in autoantibody production, the effects of ANCA-neutrophil and neutrophil-endothelial interactions, and the mechanisms of tissue damage.
Flint
Julia
J
Birmingham Children's Hospital NHS Foundation Trust, Birmingham B4 6NH, UK.
Morgan
Matthew D
MD
Savage
Caroline O S
CO
D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000276:immunology* / Q000503:physiopathology*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology* / Q000378:metabolism; D001402:B-Lymphocytes / Q000276:immunology; D002448:Cell Adhesion / Q000276:immunology; D042783:Endothelial Cells / Q000276:immunology; D006801:Humans; D018716:Molecular Mimicry / Q000276:immunology; D018375:Neutrophil Activation / Q000276:immunology; D009504:Neutrophils / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
D019268:Antibodies, Antineutrophil Cytoplasmic