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Anti-neutrophil extracellular trap antibody in a patient with relapse of anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report

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Title: Anti-neutrophil extracellular trap antibody in a patient with relapse of anti-neutrophil cytoplasmic antibody-associated vasculitis: a case report
Authors: Shida, Haruki Browse this author
Hashimoto, Nobuhiro Browse this author
Kusunoki, Yoshihiro Browse this author
Hattanda, Fumihiko Browse this author
Ogawa, Yayoi Browse this author
Hayashi, Terumasa Browse this author
Nakazawa, Daigo Browse this author
Masuda, Sakiko Browse this author
Tomaru, Utano Browse this author →KAKEN DB
Ishizu, Akihiro Browse this author →KAKEN DB
Keywords: ANCA-associated vasculitis (AAV)
Neutrophil extracellular traps (NETs)
ANCA-NETs vicious cycle
Anti-NET antibody (ANETA)
Issue Date: 22-Jun-2018
Publisher: BioMed Central
Journal Title: BMC nephrology
Volume: 19
Start Page: 145
Publisher DOI: 10.1186/s12882-018-0953-y
PMID: 29929470
Abstract: Background: Neutrophil extracellular traps (NETs) are web-like DNA decorated with antimicrobial proteins, such as myeloperoxidase (MPO), which are extruded from activated neutrophils. Although NETs are essential in innate immunity, an excessive formation of NETs has adverse effects, e.g., induction of anti-neutrophil cytoplasmic antibody (ANCA), to the hosts. Since ANCA can induce NET formation in the primed neutrophils, a positive feedback loop can be formed between NETs and ANCA, which is called "ANCA-NETs vicious cycle." Case presentation: A 79-year-old Japanese woman developed hydralazine-induced pauci-immune necrotizing crescentic glomerulonephritis with MPO-ANCA. Although the illness improved after cessation of hydralazine, MPO-ANCA-associated vasculitis relapsed 16 months later. Remission was achieved 5 months after beginning of administration of prednisone. In order to determine the involvement of ANCA-NETs vicious cycle in this patient, we examined NET degradation and induction activities in sera obtained at the disease onset (Serum A; MPO-ANCA, 107 IU/ml), at relapse (Serum B; MPO-ANCA, 195 IU/ml), at 3 months after treatment (Serum C; MPO-ANCA, 4.5 IU/ml), and at remission (Serum D; MPO-ANCA, 2.4 IU/ml). NET degradation activity was low in the all sera. NET induction activity was high in Sera A, B, and C but not in D. Additionally, we demonstrated the presence of anti-NET antibody (ANETA) in Sera B and C but not in A or D. Conclusions: The collective findings suggest NET induction potential of ANETA in the present patient and that the ANETA could contribute to the enhancement of NETs resulting in amplification of the ANCA-NETs vicious cycle.
Rights: © 2018 Haruki Shida, Nobuhiro Hashimoto, Yoshihiro Kusunoki, Fumihiko Hattanda, Yayoi Ogawa, Terumasa Hayashi, Daigo Nakazawa, Sakiko Masuda, Utano Tomaru and Akihiro Ishizu
Type: article
Appears in Collections:保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 石津 明洋

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