| Autor: |
Morris AD; Department of Renal Medicine, Royal Preston Hospital, Lancashire NHS Foundation Trust, Preston, UK. Adam.Morris@lthtr.nhs.uk., Morais CLM; School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK., Lima KMG; Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande Do Norte, Natal, Brazil., Freitas DLD; Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande Do Norte, Natal, Brazil., Brady ME; Department of Renal Medicine, Royal Preston Hospital, Lancashire NHS Foundation Trust, Preston, UK., Dhaygude AP; Department of Renal Medicine, Royal Preston Hospital, Lancashire NHS Foundation Trust, Preston, UK., Rowbottom AW; Department of Immunology, Royal Preston Hospital, Lancashire NHS Foundation Trust, Preston, UK.; School of Medicine, University of Central Lancashire, Preston, UK., Martin FL; Biocel UK Ltd, Hull, UK. flm13@biocel.uk. |
| Abstrakt: |
The current lack of a reliable biomarker of disease activity in anti-neutrophil cytoplasmic autoantibody (ANCA) associated vasculitis poses a significant clinical unmet need when determining relapsing or persisting disease. In this study, we demonstrate for the first time that attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy offers a novel and functional candidate biomarker, distinguishing active from quiescent disease with a high degree of accuracy. Paired blood and urine samples were collected within a single UK centre from patients with active disease, disease remission, disease controls and healthy controls. Three key biofluids were evaluated; plasma, serum and urine, with subsequent chemometric analysis and blind predictive model validation. Spectrochemical interrogation proved plasma to be the most conducive biofluid, with excellent separation between the two categories on PC2 direction (AUC 0.901) and 100% sensitivity (F-score 92.3%) for disease remission and 85.7% specificity (F-score 92.3%) for active disease on blind predictive modelling. This was independent of organ system involvement and current ANCA status, with similar findings observed on comparative analysis following successful remission-induction therapy (AUC > 0.9, 100% sensitivity for disease remission, F-score 75%). This promising technique is clinically translatable and warrants future larger study with longitudinal data, potentially aiding earlier intervention and individualisation of treatment. |
