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Deshayes S, Martin Silva N, Khoy K, Mariotte D, Le Mauff B, Mornex JF, Pison C, Cuvelier A, Balduyck M, Pujazon MC, Fournier M, Ait Ilalne B, Thabut G, Mal H, Aouba A. Prevalence of Anti-Neutrophil Cytoplasmic Antibodies and Associated Vasculitis in COPD Associated With Alpha-1 Antitrypsin Deficiency: An Ancillary Study to a Prospective Study on 180 French Patients. Chest 2020; 158:1919-1922. [PMID: 32417149 DOI: 10.1016/j.chest.2020.04.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/18/2020] [Accepted: 04/25/2020] [Indexed: 01/01/2023] Open
Affiliation(s)
- Samuel Deshayes
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Nicolas Martin Silva
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Kathy Khoy
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Delphine Mariotte
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Brigitte Le Mauff
- Laboratoire d'Immunologie, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France
| | - Jean-François Mornex
- Service de Pneumologie, Hospices Civils de Lyon, Lyon, France; INRA UMR754, Université Lyon 1, Lyon, France
| | - Christophe Pison
- Service Hospitalier Universitaire Pneumologie Physiologie, CHU Grenoble Alpes, Grenoble, France; INSERM U1055, Université Grenoble Alpes, Grenoble, France
| | - Antoine Cuvelier
- Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, CHU de Rouen, Rouen, France; UPRES EA 3830, Institut de Recherche et d'Innovation Biomédicale, Université Normandie Rouen, Rouen, France
| | - Malika Balduyck
- Laboratoire de Biochimie et Biologie Moléculaire, Centre de Biologie Pathologie, CHRU de Lille, Lille, France; Faculté de Pharmacie, Université de Lille Nord de France, Lille, France
| | | | - Michel Fournier
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Brahim Ait Ilalne
- INSERM U700, Université Paris Diderot-Paris 7, Paris, France; Centre d'Investigation Clinique, Hôpital Bichat, APHP, Paris, France
| | - Gabriel Thabut
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Hervé Mal
- Service de Pneumologie B et Transplantation Pulmonaire, APHP, Paris, France; INSERM U700, Université Paris Diderot-Paris 7, Paris, France
| | - Achille Aouba
- Service de Médecine Interne, Normandie University, UNICAEN, CHU de Caen Normandie, Caen, France.
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Pijnappel EN, Rijkers GT, Overveld FJV. Saint John on Patmos: Revelations of the Role of Antineutrophil Cytoplasmic Antibody (ANCA) in Vasculitis. Curr Med Chem 2019; 27:2852-2862. [PMID: 31838986 DOI: 10.2174/0929867327666191213112220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 11/08/2019] [Accepted: 11/16/2019] [Indexed: 11/22/2022]
Abstract
Diagnosis of vasculitis is based on the presence of histologic features and serological testing for antineutrophil cytoplasmic antibodies (ANCA). In patients with vasculitis, two types of ANCA have been identified: ANCA directed against the neutrophil serine protease proteinase-3 (PR3) which results in a cytoplasmic immunofluorescence pattern (c-ANCA) and ANCA directed against the neutrophil enzyme myeloperoxidase (MPO), which results in a perinuclear immunofluorescence pattern (p-ANCA). Question is if the presence of ANCA is the consequence of abnormal neutrophil adhesion, activation, and apoptosis. Or is it, through mechanisms which are not totally clear for the moment, the cause of vasculitis. In the latter case it has to be postulated that ANCA autoantigens are expressed on the cell surface of viable, or activated, or early-apoptotic neutrophils.
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Affiliation(s)
- Esther N Pijnappel
- Department. of Science, University College Roosevelt, Middelburg, Netherlands.,Faculty of Health, Medicine, and Life Science, University of Maastricht, 6211 LK Maastricht, Netherlands
| | - Ger T Rijkers
- Department. of Science, University College Roosevelt, Middelburg, Netherlands.,Laboratory of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, Netherlands.,Laboratory for Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilburg, Netherlands
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4
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Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection. Case Rep Med 2017; 2017:8140641. [PMID: 28367219 PMCID: PMC5358468 DOI: 10.1155/2017/8140641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 02/15/2017] [Indexed: 11/18/2022] Open
Abstract
The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy. Considering AAT deficiency in these cases might lead to a more timely diagnosis.
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Figueira Gonçalves JM, D'amato R. Antineutrophil cytoplasmic antibodies (ANCA)-negative vasculitis in a patient with alpha-1-antitrypsin deficiency. Arch Bronconeumol 2015; 52:172-3. [PMID: 26603444 DOI: 10.1016/j.arbres.2015.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Juan Marco Figueira Gonçalves
- Servicio de Neumología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Tenerife, España.
| | - Rosella D'amato
- Servicio de Neumología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Tenerife, España
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6
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Guttman O, Baranovski BM, Schuster R, Kaner Z, Freixo-Lima GS, Bahar N, Kalay N, Mizrahi MI, Brami I, Ochayon DE, Lewis EC. Acute-phase protein α1-anti-trypsin: diverting injurious innate and adaptive immune responses from non-authentic threats. Clin Exp Immunol 2015; 179:161-72. [PMID: 25351931 DOI: 10.1111/cei.12476] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 12/29/2022] Open
Abstract
One would assume that the anti-inflammatory activity of α1-anti-trypsin (AAT) is the result of inhibiting neutrophil enzymes. However, AAT exhibits tolerogenic activities that are difficult to explain by serine-protease inhibition or by reduced inflammatory parameters. Targets outside the serine-protease family have been identified, supporting the notion that elastase inhibition, the only functional factory release criteria for clinical-grade AAT, is over-emphasized. Non-obvious developments in the understanding of AAT biology disqualify it from being a straightforward anti-inflammatory agent: AAT does not block dendritic cell activities, nor does it promote viral and tumour susceptibilities, stunt B lymphocyte responses or render treated patients susceptible to infections; accordingly, outcomes of elevated AAT do not overlap those attained by immunosuppression. Aside from the acute-phase response, AAT rises during the third trimester of pregnancy and also in advanced age. At the molecular level, AAT docks onto cholesterol-rich lipid-rafts and circulating lipid particles, directly binds interleukin (IL)-8, ADAM metallopeptidase domain 17 (ADAM17) and danger-associated molecular pattern (DAMP) molecules, and its activity is lost to smoke, high glucose levels and bacterial proteases, introducing a novel entity - 'relative AAT deficiency'. Unlike immunosuppression, AAT appears to help the immune system to distinguish between desired responses against authentic threats, and unwanted responses fuelled by a positive feedback loop perpetuated by, and at the expense of, inflamed injured innocent bystander cells. With a remarkable clinical safety record, AAT treatment is currently tested in clinical trials for its potential benefit in a variety of categorically distinct pathologies that share at least one common driving force: cell injury.
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Affiliation(s)
- O Guttman
- Ben-Gurion University of the Negev, Faculty of Health Sciences, Department of Clinical Biochemistry and Pharmacology, Beer-Sheva, Israel
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