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45. Kongress der Deutschen Gesellschaft für Rheumatologie, 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

06.09. - 09.09.2017, Stuttgart

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Autoantibodies targeting complement receptors 3a and 5a are decreased in ANCA-associated vasculitis

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  • Sebastian Klapa - Institut für experimentelle Medizin, Sektion Maritime Medizin der Christian-Albrechts-Universität zu Kiel und Klinik für Rheumatologie und klinische Immunologie Universitätsklinikum Schleswig-Holstein Campus Lübeck, Kronshagen
  • Andreas Koch - Institut für experimentelle Medizin, Sektion Maritime Medizin, Christian-Albrechts-Universität Kiel und Universitätsklinikum Schleswig-Holstein, Kronshagen
  • Anja Kerstein - Klinik für Rheumatologie und klinische Immunologie, Universität zu Lübeck, Lübeck
  • Christian Karsten - Institut für systemische Entzündungsforschung, Universität zu Lübeck, Lübeck
  • Harald Heidecke - CellTrend GmbH, Luckenwalde, Germany, CellTrend GmbH, Luckenwalde
  • Gabriela Riemekasten - Universität zu Lübeck, Klinik für Rheumatologie und Klinische Immunologie, Lübeck
  • Peter Lamprecht - Klinik für Rheumatologie und klinische Immunologie, Universität zu Lübeck, Lübeck
  • Antje Müller - Klinik für Rheumatologie und klinische Immunologie, Universität zu Lübeck, Lübeck

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 45. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 31. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), 27. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Stuttgart, 06.-09.09.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocER.13

doi: 10.3205/17dgrh087, urn:nbn:de:0183-17dgrh0877

Published: September 4, 2017

© 2017 Klapa et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Necrotizing crescentic glomerulonephritis (NCGN) in ANCA-associated vasculitis (AAV) is characterized by scantly deposited immune complexes and complement components. However, circulating levels of the anaphylatoxin C5a are elevated in AAV and blocking of its receptor C5aR1 was protective in a murine model of NCGN. In contrast, little if any is known about autoantibodies targeting complement receptor 3a and 5a in patients with AAV.

Methods: The aim of this study was to determine if circulating autoantibodies directed against complement receptor C3a (anti-C3aR) and C5a (anti-C5aR1) are present and of diagnostic and/or prognostic value in AAV. Thus, sera of patients with AAV [granulomatosis with polyangiitis (GPA), n=49; microscopic polyangiitis (MPA), n=10] were measured by Elisa in comparison to healthy controls [HC, (n=217)]. Clinical data (BVAS, VDI, therapy) and inflammatory markers (ESR, C-reactive protein, creatinine) and diagnostic autoantibodies (anti-MPO, anti-PR3) were gathered at the time of serum sampling.

Results: Unlike in MPA patients, GPA patients displayed significantly lower titers of circulating anti-C3aR in comparison to HC. Further, the concentrations of anti-C5aR1 were decreased in both GPA and MPA, when compared to HC. In particular, GPA patients without a history of therapy using cyclophosphamide and/or rituximab exhibited a negative correlation between the concentration of anti-C5aR1 and the disease activity (BVAS).

Conclusion: These findings could be indicative of distinct roles of anti-C3aR and anti-C5aR1 in GPA and MPA. Further, anti-C5aR1 titer may be of diagnostic value in order to monitor the clinical progress of GPA.