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The Diagnostic and Clinical Utility of Autoantibodies in Systemic Vasculitis

Department of Internal Medicine, Rheumatology and Immunology, Vasculitis-Center Tübingen-Kirchheim, Medius Klinik Kirchheim, University of Tübingen, 73230 Kirchheim-Teck, Germany
Antibodies 2019, 8(2), 31; https://doi.org/10.3390/antib8020031
Received: 18 March 2019 / Revised: 14 April 2019 / Accepted: 16 April 2019 / Published: 1 May 2019
(This article belongs to the Special Issue Antibody-Based Diagnostics)
Considerable progress has been made in understanding the role of autoantibodies in systemic vasculitides (SV), and consequently testing for anti-neutrophil cytoplasmic antibodies (ANCA), anti-glomerular basement membrane antibodies (anti-GBM), and anti-C1q antibodies is helpful and necessary in the diagnosis, prognosis, and monitoring of small-vessel vasculitis. ANCA-directed proteinase 3 (PR3-) or myeloperoxidase (MPO-) are sensitive and specific serologic markers for ANCA-associated vasculitides (AAV), anti-GBM antibodies are highly specific for the patients with anti-GBM antibody disease (formerly Goodpasture’s syndrome), and autoantibodies to C1q are characteristic of hypocomlementemic urticarial vasculitis syndrome (HUVS; anti-C1q vasculitis). The results of a current EUVAS study have led to changes in the established strategy for the ANCA testing in small-vessel vasculitis. The revised 2017 international consensus recommendations for ANCA detection support the primary use PR3- and MPO-ANCA immunoassays without the categorical need for additional indirect immunofluorescence (IIF). Interestingly, the presence of PR3- and MPO-ANCA have led to the differentiation of distinct disease phenotype of AAV: PR3-ANCA-associated vasculitis (PR3-AAV), MPO-ANCA-associated vasculitis (MPO-AAV), and ANCA-negative vasculitis. Further studies on the role of these autoantibodies are required to better categorize and manage appropriately the patients with small-vessel vasculitis and to develop more targeted therapy. View Full-Text
Keywords: autoantibodies; vasculitis; diagnostic and clinical significance; proteinase 3-/myeloperoxidase-ANCA; new recommendations autoantibodies; vasculitis; diagnostic and clinical significance; proteinase 3-/myeloperoxidase-ANCA; new recommendations
MDPI and ACS Style

Csernok, E. The Diagnostic and Clinical Utility of Autoantibodies in Systemic Vasculitis. Antibodies 2019, 8, 31.

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