Segelmark M, Westman K, Wieslander J
Department of Nephrology, University Hospital, Lund, Sweden.
Clin Exp Rheumatol. 2000 Sep-Oct;18(5):629-35.
Antineutrophil cytoplasmic antibodies (ANCA) have become an established tool for the diagnosis of systemic vasculitis. The major role for ANCA testing is in diagnosing renal insufficiency of unknown origin, where a positive test indicates whether the patient will benefit from immunosuppressive treatment or not. A negative test result almost completely rules out the presence of systemic vasculitis. In this clinical setting the major antigens for ANCA are proteinase 3 and myeloperoxidase, and antibodies to these antigens can best be tested by ELISA. In other clinical settings like inflammatory bowel disease, arthritis and so on, several other ANCA specificities have been described and the IIF test is preferred. However, the clinical value of these somewhat more esoteric specificities is doubtful. New developments in assay techniques and better knowledge of specific epitopes will lead to tools for the improved diagnosis as well as follow up of patients during treatment, as has already been seen with the capture assay for PR3-ANCA.
抗中性粒细胞胞浆抗体（ANCA）已成为诊断系统性血管炎的常用工具。ANCA检测的主要作用在于诊断不明原因的肾功能不全，检测结果呈阳性表明患者是否会从免疫抑制治疗中获益。检测结果呈阴性几乎完全排除系统性血管炎的存在。在这种临床情况下，ANCA的主要抗原是蛋白酶3和髓过氧化物酶，针对这些抗原的抗体最好通过酶联免疫吸附测定（ELISA）进行检测。在其他临床情况，如炎症性肠病、关节炎等中，已描述了几种其他ANCA特异性，免疫荧光法（IIF）检测更为可取。然而，这些较为罕见的特异性的临床价值值得怀疑。检测技术的新进展以及对特定表位的更深入了解将带来有助于改善诊断以及治疗期间患者随访的工具，正如PR3-ANCA捕获测定法所显示的那样。
