Antineutrophil cytoplasmatic antibodies in patients with premature atherosclerosis: prevalence and association with risk factors

Haelst, P.L. van; Asselbergs, Folkert W.; Doormaal, Jasper J. van; Veeger, Nic J. G. M.; May, JF; Holvoet, Paul; Gans, Rob; Tervaert, Jan Willem Cohen

doi:10.1046/j.1365-2796.2002.00920.x

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…Furthermore, it has been hypothesized that not all PR3- or MPO-ANCAs are pathogenic ( 7 ). A previous study reported that ANCA did not have a major role in premature atherosclerosis, since no increased level of the autoantibody was observed ( 22 ). In some cases, including the present case, the presence of ANCA may occur synchronously with cholesterol embolism, resulting in impairment of renal function and systemic inflammation ( 11 , 12 , 14 , 15 , 17 ).…”

Section: Discussionmentioning

confidence: 98%

Anti-neutrophil cytoplasmic antibodies in cholesterol embolism: A case report and literature review

Zhang

Chen

et al. 2016

Experimental and Therapeutic Medicine

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Cholesterol embolism is a multisystemic disorder with clinical manifestations that resemble vasculitis. Anti-neutrophil cytoplasmic antibodies (ANCA) are a defining feature of ANCA-associated vasculitis, and the presence of ANCA in cholesterol embolism complicates its differential diagnosis and treatment. At present, the role of ANCA in cholesterol embolism remains unclear and no effective treatment is currently available. The present study reports the case of an Asian male who presented with spontaneous cholesterol embolism with proteinase 3 (PR3)-specific ANCA, subacute interstitial nephritis and late-developing skin lesions. The 69-year-old patient was admitted to The First Affiliated Hospital of Xiamen University (Xiamen, China) complaining of chest tightness, fatigue, progressive renal failure and refractory hypertension. In addition, transient eosinophilia was detected. Following immunosuppressive therapy with steroids and cyclophosphamide for 6 months, hemodialysis treatment was initiated. Skin lesions appeared at >1 month following hemodialysis initiation; however, they were gradually improved following treatment with atorvastatin and anti-platelet aggregation therapy for 5 months. The patient was maintained on hemodialysis for ~2 years and exhibited general good health at the most recent follow-up. In addition, 11 cases of cholesterol embolism associated with ANCA reported in the literature were discussed in the present study.

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Section: Discussionmentioning

confidence: 98%

Anti-neutrophil cytoplasmic antibodies in cholesterol embolism: A case report and literature review

Zhang

Chen

et al. 2016

Experimental and Therapeutic Medicine

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“…For example, while some found that anti-cardiolipin antibodies are raised in patients with coronary artery disease or that they could even represent an independent risk factor for myocardial infarction and cardiac death in middle-aged men, others could not elicit an association between anticardiolipin antibodies and ischemic heart disease in either men or women [9,18,19] . Anti-neutrophil cytoplasmic antibodies, which supposedly amplify the inflammatory process, appear to play no major role in premature atherosclerosis [20] .…”

Section: Discussionmentioning

confidence: 99%

Significance of Antinuclear Antibodies and Rheumatoid Factor in Patients with Advanced Peripheral Arterial Disease

Qadan¹,

Ahmed

Abdel-Jalil

et al. 2010

Med Princ Pract

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Objective: To determine whether or not elevated titers of antinuclear antibodies (ANA) and/or rheumatoid factor (RF) are associated with patients with advanced peripheral arterial disease (PAD). Subjects and Methods: A cross-sectional study was done between September 2005 and December 2006. Fifty-eight patients with clinical and angiographic evidence of PAD and 41 controls were studied. Controls had no documented history of peripheral, coronary or cerebral vascular disease. All subjects were screened for metabolic syndrome and C-reactive protein (CRP) as risk factors for peripheral vascular disease. Additionally, all were tested for anti-mitochondrial, anti-neutrophil cytoplasmic and anti-smooth muscle antibodies; those with positive results were excluded. ANA and RF were measured in sera from cases and controls. Results: One case and 3 controls had positive anti-smooth muscle antibodies and were therefore excluded from statistical analysis. Metabolic syndrome was significantly more prevalent in patients than controls (p < 0.05). Mean CRP level was 4.78 ± 7.70 and 2.65 ± 3.86 mg/dl in cases and controls, respectively (p = 0.021). ANA were detected at a titer of ≧1:40 in 6 (10.5%) of the advanced PAD patients but none of the controls; the difference was not statistically significant. RF was less prevalent in cases than controls (p < 0.05). Conclusion: RF and ANA do not appear to be associated with PAD in a Kuwaiti population.

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“…In addition to endothelial cell dysfunctions and potential predisposing inflammatory mediators, autoimmune mechanisms might be involved in the development of atherosclerosis, especially in systemic autoimmune diseases and vasculitides. ANCA status and levels, as mentioned above, do not correlate with endothelial cell dysfunctions or subclinical atherosclerosis 31,36,40,50 . Antiendothelial cell autoantibodies were detected in patients with vasculitis and their titers correlated sometimes, but not always, with disease activity 51,52 .…”

Section: Autoimmune Hypotheses For Vasculitis‐associated Premature Atmentioning

confidence: 91%

“…ANCA status and levels, as mentioned above, do not correlate with endothelial cell dysfunctions or subclinical atherosclerosis. 31,36,40,50 Antiendothelial cell autoantibodies were detected in patients with vasculitis and their titers correlated sometimes, but not always, with disease activity. 51,52 However, to date, no specific study has provided evidence supporting their role in vasculitis-associated atherosclerosis.…”

Section: Autoimmune Hypotheses For Vasculitis-associated Premature Atmentioning

confidence: 99%

Atherosclerosis in ANCA‐Associated Vasculitides

Pagnoux

Chironi

Simon

et al. 2007

Annals of the New York Academy of Sciences

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It is currently accepted that atherosclerosis is rather, or also, an inflammatory disease and, indeed, vasculitis is defined by inflammatory infiltrates in blood vessel walls, albeit initially by different predominant cell populations and in arteries of different calibers. As for other chronic systemic inflammatory diseases, premature and accelerated atherosclerosis has emerged during the last 5-10 years as an important facet of vasculitides, independently of the other risk factors of cardiovascular disease and also, apparently, corticosteroids. Chronic systemic inflammation, like persistently active vasculitis, might play a role in early atherosclerosis, through the actions of C-reactive protein (CRP), some adhesion molecules, and/or cytokines, as well as local inflammation, perhaps through locally secreted TNF-alpha and/or upregulation of matrix metalloproteinases and oxidative stress. Endothelial cell dysfunction and increased arterial stiffness have also been found in vasculitis patients. Notably, some vasculitis treatments were able to reverse some of these endothelial cell anomalies. Unlike antineutrophil cytoplasm autoantibodies (ANCA), which were not shown to correlate with a higher risk of atherosclerosis or cardiovascular events, autoantibodies to endothelial cells, heat-shock proteins, or oxidized-LDL may also be implicated, although these latter are now thought to protect against atherosclerosis. It is likely that other, as yet unidentified, factors facilitating atherosclerosis may play more important roles in vasculitides. Until their precise identification, it remains important to take into consideration and treat, every time it is necessary and possible, the other well-known cardiovascular risk factors.

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Antineutrophil cytoplasmatic antibodies in patients with premature atherosclerosis: prevalence and association with risk factors

Abstract: Abstract. van Haelst PL, Asselbergs FW, van Doormaal JJ,

Cited by 7 publications

References 30 publications

Anti-neutrophil cytoplasmic antibodies in cholesterol embolism: A case report and literature review

Anti-neutrophil cytoplasmic antibodies in cholesterol embolism: A case report and literature review

Significance of Antinuclear Antibodies and Rheumatoid Factor in Patients with Advanced Peripheral Arterial Disease

Atherosclerosis in ANCA‐Associated Vasculitides

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