Avtor/Urednik		Vizjak, Alenka; Nagode, Breda; Koselj, Mira; Rozman, Blaž; Kaplan-Pavlovčič, Staša; Košnik, Mitja; Petric, Vlasta; Ferluga, Dušan
Naslov		Antinevtrofilna citoplazemska protitelesa in njihov pomen v diagnostiki in patogenezi vaskulitisa
Prevedeni naslov		Antineutrophil cytoplasmic antibodies and their role in the diagnosis and pathogenesis of vasculitis
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 38, št. Suppl 7
Leto izdaje		1999
Obseg		str. 55-60
Jezik		slo
Abstrakt		The review discusses antineutrophil cytoplasmic antibodies (ANCA) as a useful marker in the diagnosis and a key factor in the pathogenesis of small vessel vasculitides, as well as the results of our study of 423 ANCA-positive patients. These autoantibodies are directed against various cytoplasmic antigens of neutrophil granulocytes and monocytes, far the most important being proteinase 3 and myeloperoxidase. Two staining patterns are recognized by indirect immunofluorescence: cytoplasmic and perinuclear. ELISA enables the determination of antibodies antigen specidicity. Antibodies with specificity for proteinase 3 are highly specific and sensitive for Wegener's granulomatosis and anti-myeloperoxidase antibodies for microscopic polyangiitis and idiopathic pauci-immune crescentic glomerulonephritis. The generally accepted term of ANCA associated vasculitides includes also Churg-Strauss syndrome. However, ANCA have occasionally been found to be positive in various other diseases, characteristically in low values, with and atypical immunofluorescence pattern and specificity for myeloperoxidase, and the rare of unknown ANCA antigens.
Izvleček		Podan je pregled o antinevtrofilnih citoplazemskih protitelesih (ANCA), ki so pomembna za diagnozo in imajo osrednjo vlogo v patogenezi maložilnih vaskulitisov, ter lastni izsledki študije 423 ANCA-pozitivnih bolnikov. Protitelesa so usmerjena proti različnim citoplazemskim antigenom nevtrofilnih granulocitov in monocitov, od katerih sta daleč najpomembnejša proteinaza 3 in mieloperoksidaza. Z indirektno imunofluorescenco ugotovimo dva vzorca: citoplazemskega in perinuklearnega. Antigensko specifičnost protiteles ugotavljamo z ELISA. Protitelesa proti proteinazi 3 so visoko specifična in občutljiva za Wegenerjevo granulomatozo, anti-mieloperoksidazna protitelesa pa za mikroskopski poliangiitis in idiopatski, imunsko borni polmesečasti glomerulonefritis. Splošno sprejeta kategorija ANCA-pozitivnih vaskulitisov vključuje še Churg-Straussin sindrom. Pozitivna ANCA občasno najdemo tudi pri številnih drugih boleznih, vendar značilno v nizkih titrih, z atipičnim vzorcem v imunofluorescenci in specifičnostjo za mieloperoksidazo ali pa druge in nepoznane ANCA-antigene.
Deskriptorji		VASCULITIS ANTIBODIES, ANTINEUTROPHIL CYTOPLASMIC WEGENER'S GRANULOMATOSIS VASCULITIS, ALLERGIC CUTANEOUS CHURG-STRAUSS SYNDROME POLYARTERITIS NODOSA