Pathophysiological importance of antineutrophil antibodies in vasculitis.
OBJECTIVE
We endeavour to provide a brief overview of the recent advances in understanding of how antineutrophil cytoplasmic antibodies (ANCAs) contribute to the pathophysiology of vasculitis.


RESULTS
Substantial progress has been made in our understanding of the immunopathogenesis of ANCA-associated vasculitides. Compelling evidence from in-vitro studies and experimental models in conjunction with clinical trials has confirmed that ANCAs directly contribute to the evolution and progression of the disease process. A new ANCA, directed against human lysosome membrane protein-2 (LAMP-2), has recently been described as a sensitive and specific marker for renal vasculitis and we discuss its potential impact for diagnosis and therapy. Furthermore, high-throughput approaches are starting to identify genetic patterns that may identify patients likely to respond to specific therapy or having a high probability of relapse.


CONCLUSIONS
It has become increasingly clear over the last two decades that ANCA IgG is pathogenic in vasculitis. Novel therapies aimed at selected cell populations or blocking specific pathogenic pathways offer hope for more selectively treating this heterogeneous group of patients, while avoiding nonspecific immunosuppression and its adverse effects.
School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
Neil
N
Basu
Lars-Peter
LP
Erwig
D000818:Animals; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000276:immunology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D000918:Antibody Specificity / Q000276:immunology; D003167:Complement Activation / Q000276:immunology; D003165:Complement System Proteins / Q000276:immunology; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D052119:Lysosomal-Associated Membrane Protein 2 / Q000276:immunology; D016176:T-Lymphocyte Subsets / Q000276:immunology; D014657:Vasculitis / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; C497811:LAMP2 protein, human; D052119:Lysosomal-Associated Membrane Protein 2; D003165:Complement System Proteins