title: Serum anti-lysosomal-associated membrane protein-2 antibody levels in cutaneous polyarteritis nodosa.
abstract: Lysosomal-associated membrane protein-2 (LAMP-2) is a target antigen for anti-neutrophil cytoplasmic antibodies (ANCAs), which are closely linked to a subset of primary systemic vasculitides. Cutaneous polyarteritis nodosa (CPN) is a necrotizing vasculitis of small to medium-sized arteries within the skin. We measured levels of serum anti-LAMP-2 antibody in 50 patients with CPN, 8 with microscopic polyangiitis (MPA), and 34 healthy persons. We also investigated the presence of ANCA in patients with CPN using indirect immunofluorescence (IIF), a direct ELISA and a capture ELISA specific for myeloperoxidase (MPO) and proteinase 3 (PR3). Serum anti-LAMP-2 antibody levels differed significantly between patients with CPN (0.263 U/ml) and those with MPA (0.180 U/ml) (p = 0.0102). Serum of all patients with CPN was negative for MPO-ANCA and PR3-ANCA by both direct ELISA and capture ELISA. In contrast, IIF assay revealed ANCA in 42 (84.0%) of the 50 CPN patients. Serum anti-LAMP-2 antibody levels in the perinuclear ANCA (P-ANCA) group were significantly elevated compared with the non-ANCA group (p = 0.0147). We suggest that anti-LAMP-2 antibody could play an important role in the pathogenesis of CPN in the presence of P-ANCA detected by IIF.
authors.affiliation: Department of Dermatology, St Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan. tami@marianna-u.ac.jp
authors.forename: Tamihiro
authors.initials: T
authors.lastname: Kawakami
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ishizu
authors.forename: Yosihiro
authors.initials: Y
authors.lastname: Arimura
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Soma
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D016022:Case-Control Studies; D003176:Complement C3 / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D052119:Lysosomal-Associated Membrane Protein 2 / Q000276:immunology*; D008297:Male; D055953:Microscopic Polyangiitis / Q000276:immunology; D008875:Middle Aged; D053146:Myeloblastin / Q000276:immunology; D009195:Peroxidase / Q000276:immunology; D010488:Polyarteritis Nodosa / Q000276:immunology*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D003176:Complement C3; D052119:Lysosomal-Associated Membrane Protein 2; D009195:Peroxidase; D053146:Myeloblastin