Anti-myeloperoxidase and proteinase 3 antibodies for nephritis flare prediction in anti-neutrophil cytoplasmic antibody-associated vasculitis.

Autor:	Rodríguez E; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain., Latzke B; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain., Sierra M; Servicio de Nefrología, Hospital San Pedro de Logroño, La Rioja, Spain., Romera AM; Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Siedel D; Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Agraz I; Servicio de Nefrologia, Hospital Universitario Valle Hebrón, Barcelona, Spain., Soler MJ; Servicio de Nefrologia, Hospital Universitario Valle Hebrón, Barcelona, Spain., García-Carro C; Servicio de Nefrologia, Hospital Universitario Valle Hebrón, Barcelona, Spain., Draibe J; Hospital Universitario de Bellvitge, Barcelona, Spain., de la Prada FJ; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, Spain., Villacorta J; Servicio Nefrologia, Hospital Universitario Ramón y Cajal, Madrid, Spain., Buxeda A; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain., Sierra-Ochoa A; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain., Lozano I; Laboratori de Referència de Catalunya, Barcelona, Spain., Durán X; AMIB, Institut Hospital del Mar Investigación Médica, Barcelona, Spain., Barrios C; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain., Pascual J; Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2022 Mar 25; Vol. 37 (4), pp. 697-704.
DOI:	10.1093/ndt/gfab020
Abstrakt:	Background: The value of myeloperoxidase (MPO) and proteinase 3 (PR3) antibody titres in the assessment of renal disease activity and flare prediction in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is not well known. Methods: We performed a retrospective study including 113 AVV patients with renal biopsy-proven pauci-immune necrotizing glomerulonephritis from seven Spanish hospitals. The main inclusion criteria were assessment of MPO antibodies using multiplex flow immunoassay and PR3 antibody measurements using immunoassay chemiluminescence with an identical range of values for all participating centres. Results: Serum MPO antibodies 3 ± 1.2 months before relapse were higher in patients who relapsed [19.2 ± 12.2 versus 3.2 ± 5.1 antibody index (AI); P < 0.001]. The discrimination value of MPO antibodies 3 months before renal relapse had an area under the receiver operating characteristics curve (AUC) of 0.82 [95% confidence interval (CI) 0.73-0.92; P < 0.001]. ΔMPO antibodies (change in antibodies titration 6 months before relapse) were higher in patients who relapsed (8.3 ± 12 versus 0.9 ± 3.1 AI; P = 0.001). The discrimination value of ΔMPO had an AUC of 0.76 (95% CI 0.63-0.88; P < 0.001). The positive predictive value of renal relapse in PR3 patients is 100% and the negative predictive value of renal relapse in patients with PR3-positive titres is 57.1%. Serum PR3 antibodies were higher in patients who relapsed 2.8 ± 1.4 months before relapse (58.6 ± 24.6 versus 2.0 ± 0.6 AI; P < 0.001). Conclusions: MPO level monitoring using multiplex flow immunoassay and PR3 measurements using immunoassay chemiluminescence are useful and sensitive tools for the prediction of renal relapse in the follow-up of AAV patients with renal disease and relevant surrogate markers of renal disease activity. (© The Author(s) 2021. Published by Oxford University Press on behalf of the ERA.)
Databáze:	MEDLINE
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