title: Current and novel biomarkers in anti-neutrophil cytoplasm-associated vasculitis.
abstract: Anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is characterized by a variable disease course, with up to 50% of patients having one relapse within 5 years and many progressing to end-stage organ damage despite modern treatment strategies. Moreover, complications arising from treatment dominate the causes of mortality and morbidity both early and late during disease, especially in the elderly and those with severe renal involvement, and there is additional uncertainty as to how long treatment should be continued. There is, therefore, an urgent clinical need to identify robust biomarkers to better predict treatment responses, risk of disease relapse and eventual complete clinical and immunological quiescence. To date, no such biomarkers exist, but better understanding of disease pathogenesis and the underlying immune dysfunction has provided some potential candidates linked to the discovery of new antibodies, different leukocyte activation states, the role of the alternative complement pathway and markers of vascular activation. With all promising new biomarkers, there is the need to rapidly replicate and validate early findings using large biobanks of samples that could be brought together by leaders in the field.
authors.affiliation: Nephrology Department , Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Juliana Bordignon
authors.initials: JB
authors.lastname: Draibe
authors.affiliation: Nephrology Department , Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fulladosa
authors.affiliation: Nephrology Department , Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Cruzado
authors.affiliation: Nephrology Department , Hospital Universitari de Bellvitge , Barcelona , Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Torras
authors.affiliation: UCLCentre for Nephrology , Royal Free Hospital , London , UK.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Salama
keywords: ANCA-associated vasculitis; biomarkers; glomerulonephritis