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Related Experiment Videos

ANCA-Associated Vasculitis Pathogenesis: A Commentary.

Eric J Gapud1, Philip Seo1, Brendan Antiochos2

  • 1Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Center Tower, Ste. 5300, Baltimore, MD, 21224, USA.

Current Rheumatology Reports
|April 1, 2017
PubMed
Summary
This summary is machine-generated.

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ANCA-associated vasculitides, characterized by anti-neutrophil cytoplasmic antibodies (ANCAs), may involve monocytes and T cells more than previously thought. Revisiting neutrophil-centric views could reveal new therapeutic targets and biomarkers for these rare diseases.

Area of Science:

  • Immunology
  • Rheumatology
  • Pathogenesis of autoimmune diseases

Background:

  • ANCA-associated vasculitides (AAV) are small vessel vasculitides defined by autoantibodies against neutrophil cytoplasmic antigens (ANCAs), primarily PR3 and MPO.
  • Current understanding of AAV pathogenesis heavily emphasizes neutrophil biology due to neutrophils expressing ANCA autoantigens.

Purpose of the Study:

  • To review the current clinical and molecular immunology of AAV.
  • To discuss knowledge gaps in understanding the pathogenic mechanisms of AAV.
  • To re-evaluate the central role of neutrophils in AAV pathogenesis.

Main Methods:

  • Literature review of clinical and molecular immunology studies on AAV.
  • Analysis of genetic, clinical, and cellular biology observations.
Keywords:
AAV pathogenesisANCA-associated vasculitisEosinophilic granulomatosis with polyangiitisGranulomatosis with polyangiitisMicroscopic polyangiitis

Related Experiment Videos

  • Re-evaluation of existing pathogenetic models.

    • Main Results:

    • Genetic, clinical, and cellular data suggest roles for monocytes and T cells in AAV pathogenesis.
    • A purely neutrophil-centric view cannot fully explain all observations in AAV.
    • Alternative immune cell mediators may play under-appreciated roles.

    Conclusions:

    • The pathogenesis of AAV may require a broader focus beyond neutrophils.
    • Re-focusing on monocytes and T cells could uncover novel therapeutic targets.
    • Identifying roles for other immune cells may lead to better biomarkers for disease activity.