Plasma levels of soluble interleukin 2 receptor, soluble CD30, interleukin 10 and B cell activator of the tumour necrosis factor family during follow-up in vasculitis associated with proteinase 3-antineutrophil cytoplasmic antibodies: associations with disease activity and relapse

• Published in: Annals of the rheumatic diseases Vol. 65; no. 11; pp. 1484 - 1489
• Main Authors: Sanders, J-S F, Huitma, M G, Kallenberg, C G M, Stegeman, C A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.11.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; ANCA; Antibodies, Antineutrophil Cytoplasmic - blood; antineutrophil cytoplasmic antibody; B cell activator of the tumour necrosis factor family; B-Cell Activating Factor; BAFF; Biological and medical sciences; Biomarkers - blood; Birmingham Vasculitis Activity Score; BVAS; C reactive protein; C-ANCA; CRP; Cyclophosphamide - therapeutic use; Cytokines; cytoplasmic antineutrophil cytoplasmic antibody; Disease; Diseases of the osteoarticular system; Drug Therapy, Combination; Extended Report; Female; Gangrene; Glucocorticoids - therapeutic use; Humans; IIF; Immunoglobulins; Immunosuppressive Agents - therapeutic use; indirect immunofluorescence; Interleukin-10 - blood; Ki-1 Antigen - blood; Lymphocyte Activation - immunology; Lymphocytes; Male; Medical sciences; Membrane Proteins - blood; Middle Aged; Myeloblastin; Plasma; PR3-ANCA; Prednisolone - therapeutic use; proteinase 3-antineutrophil cytoplasmic antibodies; Receptors, Interleukin-2 - blood; Retrospective Studies; Rheumatoid arthritis; Rodents; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; sCD30; Serine Endopeptidases - immunology; Severity of Illness Index; sIL2R; SLE; Solubility; soluble CD30; soluble interleukin 2 receptor; systemic lupus erythematosus; T cell receptors; T-Lymphocytes - immunology; Tumor Necrosis Factor-alpha; Tumor necrosis factor-TNF; Vasculitis - drug therapy; Vasculitis - immunology; Vascular disease; Relapse; Vasculitis; Antineutrophil cytoplasmic antibody; Interleukin 2; Family study; Rheumatology; Cardiovascular disease; β Cell; Tumor cell; Necrosis; Blood plasma
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2005.046219

Objectives: To evaluate whether T cell activation, as reflected by levels of soluble interleukin 2 receptor (sIL2R), soluble CD30 (sCD30), IL-10 and B cell activator of the tumour necrosis factor family (BAFF) at diagnosis and during initial follow-up, is predictive for persistent or renewed antineutrophil cytoplasmic antibody (ANCA) positivity and clinical relapse in patients with vasculitis associated with proteinase 3-antineutrophil cytoplasmic antibodies (PR3-ANCA). Methods: 87 Patients with PR3-ANCA-associated vasculitis and at least 2 years of follow-up were included in the study. At diagnosis, and at 3, 6, 12, 18 and 24 months after diagnosis, cytoplasmic ANCA titres were detected by indirect immunofluorescence (IIF), and PR3-ANCA, sIL2R, sCD30, IL-10 and BAFF levels were assessed by ELISA. 31 healthy volunteers provided plasma samples for comparison. Levels of immune markers were related to ANCA positivity and relapse during follow-up. Results: Plasma levels of sIL2R, sCD30 and BAFF were higher in patients than in controls at all time points. Plasma levels of sIL2R, sCD30 and IL-10 were higher at diagnosis and relapse than during remission. At 18 months, sCD30 (p<0.001) and sIL2R levels (p = 0.01) were significantly higher in PR3-ANCA-positive patients (detected by ELISA) than in PR3-ANCA-negative patients. ANCA-positive patients detected by ELISA or IIF at 24 months had significantly higher plasma sCD30 levels (p = 0.02 and p = 0.03, respectively) than ANCA-negative patients. Conclusion: Increased T cell activation in patients with ANCA-associated vasculitis in remission during and after immunosuppressive treatment is associated with persistent or renewed ANCA positivity.