Monitoring disease activity in antineutrophil antibody-associated vasculitis

Area of Science:

• Rheumatology
• Immunology
• Nephrology

Background:

• Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is a group of multisystem disorders characterized by relapsing and remitting phases, often with subclinical progression.
• AAV encompasses microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA), and renal-limited vasculitis (RLV).
• While ANCA are characteristic, their absence does not exclude diagnosis, complicating disease identification.

Purpose of the Study:

• To review current understanding of AAV pathogenesis and pathophysiology.
• To identify and discuss promising biomarkers for AAV monitoring and treatment adaptation.
• To address the lack of established biomarker-based algorithms in AAV management.

Main Methods:

• Comprehensive literature review of recent studies on AAV biomarkers.
• Analysis of biomarkers related to disease activity, relapse, and treatment response.
• Synthesis of findings to evaluate the potential clinical utility of identified biomarkers.

Main Results:

• Several biomarkers show potential for monitoring AAV activity and predicting relapses.
• Biomarkers may aid in adapting treatment strategies to individual patient disease courses.
• Current diagnostic and monitoring approaches often rely on a trial-and-error basis due to limited reliable biomarkers.

Conclusions:

• Reliable biomarker-based monitoring and treatment algorithms for AAV are still lacking.
• Further research is needed to validate promising biomarkers for clinical application in AAV.
• Improved biomarker utilization could lead to more personalized and effective AAV management.