Antineutrophil Cytoplasmic Autoantibodies: How Are They Detected and What Is Their Use for Diagnosis, Classification and Follow-up?

Jan Willem Cohen Tervaert*, Jan Damoiseaux

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

57 Citations (Web of Science)

Abstract

Antineutrophil cytoplasmic antibodies (ANCA) are traditionally detected by an indirect immunofluorescence technique. According to the international consensus on ANCA testing, ANCA should also be tested by antigen-specific tests for myeloperoxidase-ANCA and proteinase 3-ANCA. The direct noncompetitive enzyme-linked immunosorbent assay (ELISA) used to be the method of choice. Nowadays, these assays are called "first-generation" assays. Second-generation tests (capture ELISA) or third-generation tests (anchor ELISA) are more sensitive and specific for ANCA testing. We postulate that ANCA as detected by these newer ANCA tests may replace the need to perform indirect immunofluorescence-based assays. For classification of patients, ANCA serotype seems more important than classifying patients according to their clinical subtype, since genetics, clinical manifestations and response to therapy are more related to ANCA serotype than to clinical subtype. Detection of ANCA to monitor disease activity is still a controversial issue. Treatment based on ANCA levels is at present only experimentally performed in those patients who are treated with B-cell depletion therapy with rituximab. Future studies are needed to establish whether this way of monitoring patients is warranted.
Original languageEnglish
Pages (from-to)211-219
JournalClinical Reviews in Allergy & Immunology
Volume43
Issue number3
DOIs
Publication statusPublished - Dec 2012

Keywords

  • ANCA
  • PR3-ANCA
  • MPO-ANCA
  • Vasculitis
  • Glomerulonephritis
  • Classification

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