Urinary Levels of High Mobility Group Box-1 Are Associated with Disease Activity in Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis

Ma, Tiantian; Wang, Huan; Wang, Chen; Chang, Dong‐Yuan; Zhao, Ming‐Hui; Chen, Min

doi:10.1371/journal.pone.0123586

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…[15] Ma et al study showed that urinary levels of HMGB1 may be associated with the disease activity in AAV patients. [29] This is similar to our results. However, de Souza et al found that HMGB1 levels were similar between AAV patients and HC and no significant differences were found regarding mean HMGB1 levels among AAV disease subsets.…”

Section: Discussionsupporting

confidence: 93%

Association of serum high mobility group box 1 levels with disease activity and renal involvement in patients with systemic vasculitis

Zhu

et al. 2019

Medicine

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High mobility group box 1 (HMGB1) is a kind of proinflammatory mediator that acts as an alarmin when released by dying, injured or activated cells. Previous studies have reported that HMGB1 are closely linked to antineutrophil cytoplasmic antibody-associated vasculitis (AAV). The present study aimed to evaluate whether serum HMGB1 levels were associated with systemic vasculitis (VAs). The study population consisted of 51 patients with VAs, 46 patients with essential hypertension (EH) and 46 healthy controls (HC). Thirty-five patients with VAs had in active stage and 16 patients with VAs in an inactive stage. Furthermore, 31 patients with VAs had renal involvement, the other 20 patients were selected for without renal involvement. Serum HMGB1 levels were measured by enzyme-linked immunosorbent assay. Associations between serum HMGB1 levels with clinical and laboratory parameters were analyzed. Serum HMGB1 levels in patients with VAs were significantly higher than in EH and HC (all P < .05), and no difference regarding serum HMGB1 levels could be found between EH and HC ( P = .208). Serum HMGB1 levels in VAs patients with active stage were significantly higher than those in HC and VAs patients with inactive stage (all P < .05). Patients with renal involvement and non-renal involvement had increased HMGB1 levels compared with HC (all P < .05). In addition, serum HMGB1 levels were significantly higher in patients with renal involvement compared with non-renal involvement patients ( P = .001). Correlation analysis showed that serum HMGB1 levels were positive significant correlated with the Birmingham Vasculitis Activity Score, hypersensitive C reactive protein (Hs-CRP), serum creatinine (Scr) and 24-hour proteinuria (all P < .05). Among the subsets of VAs, serum HMGB1 levels were significantly higher in AAV, polyarteritis nodosa (PAN) and takayasu arteritis (TA) than in HC (all P < .05). More interestingly, serum HMGB1 were significantly higher in patients with PAN compared with AAV and TA patients (all P < .05). Furthermore, there was positive correlation between serum HMGB1 levels and Hs-CRP, Scr, and 24-hour proteinuria in patients with PAN (all P < .05). Serum HMGB1 levels are increased in patients with VAs compared with HC and EH and can reflect the disease activity and renal involvement.

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Section: Discussionsupporting

confidence: 93%

Association of serum high mobility group box 1 levels with disease activity and renal involvement in patients with systemic vasculitis

Zhu

et al. 2019

Medicine

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“…It was found in our study that the levels of serum NGAL closely correlated with the Birmingham Vasculitis Activity Score as well as the level of erythrocyte sedimentation rate, C-reactive protein and ANCA [53]. Other biomarkers which could reflect the disease activity of AAV include circulating and urinary levels of high mobility group box-1, circulating levels of anti-plasminogen antibodies and circulating levels of D-dimer [54,55,56,57]. …”

Section: Outcomes Of Aav In Chinamentioning

confidence: 89%

The Prevalence and Management of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in China

Chen

et al. 2015

Kidney Dis

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Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) comprises microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) and eosinophilic GPA (EGPA). Myeloperoxidase (MPO) and proteinase 3 (PR3) are the main antigens for ANCA. AAV is a common multisystem autoimmune disease and most of the studies on AAV have been conducted in Western countries. Nowadays in China many efforts are made to investigate this disease. Summary: This review highlights the progress in the prevalence, management and outcomes of AAV in Chinese patients. With respect to the prevalence of AAV, though there are no precise data, AAV is not rare in the Chinese population. In Chinese patients with AAV there is a striking preponderance of MPA, and MPO-ANCA is much more common than PR3-ANCA. Even in patients with GPA there is a predominance of MPO-ANCA over PR3-ANCA. Propylthiouracil-induced AAV and ANCA-negative pauci-immune glomerulonephritis are stated in this review as well. With respect to the management of AAV, glucocorticoids in combination with cyclophosphamide remain the mainstay of induction therapy. Besides, we describe predictors of different outcomes in Chinese patients, including mortality, relapse, treatment resistance and end-stage renal disease. Key Messages: AAV is not rare in the Chinese population. The disease spectrum and subtypes of ANCA are different between patients with AAV in China and Western countries. The treatment strategy for AAV in China is in consistency with that in Western countries. Predictors of different clinical outcomes are provided. Facts from East and West: Treatment options for AAV are shared between the East and West, with corticosteroid combined with cyclophosphamide being the standard regimen for inductive therapy and switching to azathioprine after remission. The major cause of death in treated patients is infection related to immunosuppressive therapy within the first year after diagnosis, and this rate might be higher in China than in Western countries. Western studies demonstrated the efficacy and safety of rituximab for induction of remission in cases with relatively mild disease and maintenance therapy, but this agent is rarely used in China.

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“…In another AAV cohort [24], plasma levels of HMGB1 correlated with BVAS, serum creatinine, and eGFR, suggesting that circulating HMGB1 might reflect the disease activity and renal involvement of AAV. The same authors [25] reported increased urinary HMGB1 levels in active AAV patients, which correlated with disease activity. On the contrary, other studies found no difference regarding serum HMGB1 levels among AAV disease subsets and healthy controls [26].…”

Section: Discussionmentioning

confidence: 73%

Microparticles expressing myeloperoxidase as potential biomarkers in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV)

et al. 2020

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To investigate presence of circulating myeloperoxidase-positive microparticles (MPO + MPs) in relation to disease activity in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Forty-six patients with AAV and 23 age-and sex-matched healthy controls were included. Vasculitis disease activity was assessed using the Birmingham Vasculitis Activity Score (BVAS). MPs were analyzed in citrate plasma by flow cytometry and phenotyped based on MPO expression and co-expression of pentraxin-3 (PTX3), high mobility group box 1 protein (HMGB1), and tumor necrosis factor-like weak inducer of apoptosis (TWEAK). Serum levels of PTX3, sTWEAK, and HMGB1 were also determined. Twenty-three patients had active vasculitis (BVAS ≥ 1). Concentrations of MPO + MPs expressing PTX3, HMGB1, and TWEAK were significantly higher in patients compared to healthy controls (p < 0.001, p < 0.01, p < 0.001, respectively), while concentrations of PTX3 + and HMGB1 + MPO + MPs were significantly higher in active AAV compared to patients in remission. MPO + MPs expressing either PTX3 or HMGB1 were associated with BVAS (r = 0.5, p < 0.001; r = 0.3, p = 0.04, respectively). Significantly higher serum PTX3 levels were found in active-than in inactive AAV (p < 0.001), correlating strongly with BVAS (r = 0.7, p < 0.001). Serum levels of sTWEAK and HMGB1 did not differ between patients and controls. Concentration of MPO + MPs is increased in plasma from AAV patients compared to healthy individuals. PTX3 in serum as well as PTX3 and HMGB1 expressed on MPO + MPs were associated with disease activity in the investigated patients. Key messages & Myeloperoxidase-positive microparticles (MPO + MPs) are increased in plasma from patients with ANCA-associated vasculitis. & Concentrations of MPO + MPs expressing PTX3, HMGB1, and TWEAK were significantly higher in patients compared to healthy controls. & MPO + MPs expressing PTX3 and HMGB1 are associated with disease activity in ANCA-associated vasculitis.

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Urinary Levels of High Mobility Group Box-1 Are Associated with Disease Activity in Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis

Cited by 14 publications

References 24 publications

Association of serum high mobility group box 1 levels with disease activity and renal involvement in patients with systemic vasculitis

Association of serum high mobility group box 1 levels with disease activity and renal involvement in patients with systemic vasculitis

The Prevalence and Management of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in China

Microparticles expressing myeloperoxidase as potential biomarkers in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV)

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