Antibodies to proteinase-3 and myeloperoxidase in systemic vasculitis

Abstract

Aim. To investigate occurrence and diagnostic significance of antibodies to proteinase-3 (aPR-3) and myeloperoxidase (aMPO) in systemic vasculitis (SV). Material and methods. A total of 98 patients with different forms of SV were examined: nonspecific aortoarteritis (NAA, n = 18), nodular polyarteritis (NP, n = 18), Wegener granulomatosis (WG, n = 20), obliterating thrombangiitis (ОТ, n - 21), and hemorrhagic vasculitis (HV, n = 21). Eight patients with primary antiphospholipid syndome (PAPS) and 20 donors comprised a control group. aPR-3 and aMPO were detected by solid-phase enzyme immunoassay using kits ORGenTec Diagnostica GmbH. Results. aPR-3 were detected in 1 (5.6%) patient with NP and in 3 (14.3%) patients with HV. aPR3 were detected in 13 (65%) of 20 patients with WG being significantly more frequent not only vs controls (0%) but in some forms of SV and PAPS (p 15 U/ml) they are highly sensitive and specific for this vasculitis. aMPO were detected in 1 of 18 patients with NP, in 1 of 21 - with ОТ, in 3 of 21 - with HV and in 2 of 21 - w,th NAA. None patients with WG or PAPS had aMPO. aMPO were detected in NP and HV in high activity of inflammation. Part of the patients had affected kidneys. Conclusion. Thus, WG is characterized by the presence and high concentration ofaPR-3. In the latter case aPR-3 have high (100%) sensitivity and specificity for diagnosis of WG. Detection ofaPR-3 can be used as an additional laboratory test for diagnosis of WG and estimation of its activity.

Keywords

• systemic vasculitis
• antibodies to proteinase-3
• antibodies to myeloperoxidase