Evaluation of a new fluorescent-enzyme immuno-assay for diagnosis and follow-up of ANCA-associated vasculitis

被引:40
作者
Damoiseaux, JGMC
Slot, MC
Vaessen, M
Stegeman, CA
Van Paassen, P
Tervaert, JWC
机构
[1] Univ Hosp Maastricht, Dept Clin & Expt Immunol, NL-6202 AZ Maastricht, Netherlands
[2] Univ Groningen Hosp, Dept Nephrol, Groningen, Netherlands
关键词
ANCA; fluorescent-enzyme immuno-assay; myeloperoxidase; proteinase; 3; vasculitis;
D O I
10.1007/s10875-005-3863-2
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In this study we have evaluated a new, fully automated fluorescent-enzyme immuno-assay (FEIA) for detection and quantification of anti-PR3 and anti-MPO ANCA in diagnosis and follow-up of ANCA-associated small vessel vasculitis (AAV). PR3- and MPO-ANCA were determined by FEIA technology in (1) sera of 87 consecutive patients with biopsy-proven, pauci-immune necrotizing crescentic glomerulonephritis (NCGN) and 72 controls; (2) 120 sera (60 patients with Wegener's granulomatosis and 60 controls) that were previously used in a multicentre comparison of direct and capture ELISAs for PR3-ANCA; (3) in samples preceding relapse in 23 PR3-AAV patients with and 23 matched PR3-AAV patients without relapse for prediction of relapses. PR3- and/or MPO-ANCA detection in pauci-immune NCGN by FEIA revealed an overall sensitivity of 82.8%. The FEIA specificity was 96% and 100% for PR3- and MPO-ANCA, respectively. The overall sensitivity of MPO- and PR3-ANCA could be increased to 88.5% by lowering the cut-off values without affecting the specificity (ROC-curve analysis), which is similar to a multistep ANCA procedure that combines indirect immunofluorescence with direct and capture ELISAs. The sensitivity for Wegener's granulomatosis (WG) of the PR3-ANCA FEIA (60%) was more comparable to direct ELISAs (64%) than to capture ELISAs (74%). A rise of 100% in ANCA level as measured by FEIA appeared optimal (ROC-curve) for prediction of relapses and such a rise was observed in 26 patients. In 18 of these 26 patients the rise was followed by a relapse (PPV 69%), whereas in 15 of the 20 patients without a rise no relapse was observed (NPV 75%). In conclusion, detection of PR3- and MPO-ANCA by FEIA has excellent performance in terms of diagnosis of AAV patients. Furthermore, detection of rises in PR3-ANCA by FEIA for prediction of relapses gives results comparable to other techniques.
引用
收藏
页码:202 / 208
页数:7
相关论文
共 19 条
  • [1] Boomsma MM, 2000, ARTHRITIS RHEUM-US, V43, P2025, DOI 10.1002/1529-0131(200009)43:9<2025::AID-ANR13>3.0.CO
  • [2] 2-O
  • [3] Image analysis: a novel approach for the quantification of antineutrophil cytoplasmic antibody levels in patients with Wegener's granulomatosis
    Boomsma, MM
    Damoiseaux, JGMC
    Stegeman, CA
    Kallenberg, CGM
    Patnaik, M
    Peter, JB
    Tervaert, JWC
    [J]. JOURNAL OF IMMUNOLOGICAL METHODS, 2003, 274 (1-2) : 27 - 35
  • [4] Native and recombinant proteins to analyze auto-antibodies to myeloperoxidase in pauci-immune crescentic glomerulonephritis
    Boomsma, MM
    Stegeman, CA
    Oost-Kort, WW
    Kallenberg, CGM
    Moguilevsky, N
    Limburg, PC
    Tervaert, JWC
    [J]. JOURNAL OF IMMUNOLOGICAL METHODS, 2001, 254 (1-2) : 47 - 58
  • [5] COHENTERVAERT JW, 1990, KIDNEY INT, V37, P799
  • [6] Evaluation of capture ELISA for detection of antineutrophil cytoplasmic antibodies directed against proteinase 3 in Wegener's granulomatosis: first results from a multicentre study
    Csernok, E
    Holle, J
    Hellmich, B
    Willem, J
    Tervaert, C
    Kallenberg, CGM
    Limburg, PC
    Niles, J
    Pan, GL
    Specks, U
    Westman, K
    Wieslander, J
    De Groot, K
    Gross, WL
    [J]. RHEUMATOLOGY, 2004, 43 (02) : 174 - 180
  • [7] Small-vessel vasculitis
    Jennette, JC
    Falk, RJ
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (21) : 1512 - 1523
  • [8] NOMENCLATURE OF SYSTEMIC VASCULITIDES - PROPOSAL OF AN INTERNATIONAL CONSENSUS CONFERENCE
    JENNETTE, JC
    FALK, RJ
    ANDRASSY, K
    BACON, PA
    CHURG, J
    GROSS, WL
    HAGEN, EC
    HOFFMAN, GS
    HUNDER, GG
    KALLENBERG, CGM
    MCCLUSKEY, RT
    SINICO, RA
    REES, AJ
    VANES, LA
    WALDHERR, R
    WIIK, A
    [J]. ARTHRITIS AND RHEUMATISM, 1994, 37 (02): : 187 - 192
  • [9] KALLENBERG CG, 1992, AM J MED, V933, P675
  • [10] Prevalence of antineutrophil cytoplasmic antibodies in a large inception cohort of patients with connective tissue disease
    Merkel, PA
    Polisson, RP
    Chang, YC
    Skates, SJ
    Niles, JL
    [J]. ANNALS OF INTERNAL MEDICINE, 1997, 126 (11) : 866 - +