Yoshida M, Nagasawa T
Renal Unit of Department of Internal Medicine, Hachioji Medical Center, Tokyo Medical College, Japan.
Nihon Jinzo Gakkai Shi. 1992 Apr;34(4):371-8.
The present study was undertaken to determine the anti-neutrophil cytoplasmic antibody (ANCA) levels in 96 patients with various collagen diseases associated with renal vasculitis and vasculitic syndrome in Japan. The results indicated that cytoplasmic(C)-ANCA is an autoantibody highly specific to Wegener's granulomatosis (WG) and that it is also active in renal injury. The relationships between ANCA and focal segmental necrotizing GN, i.e., renal vasculitis as proposed by Balow, were investigated. Perinuclear(P)-ANCA was detected with high sensitivity and specificity in renal vasculitis without WG, and the severity of necrotizing and crescentic nephritis in WG was correlated especially well with the C-ANCA titer. Detection of ANCA is considered clinically useful for the etiological differentiation of renal vasculitis, suggesting the possibility that C-ANCA may be involved in the onset of vasculitis of the glomerular capillary vessels in WG. The presence of C-ANCA and cytokines (IL-1 beta and TNF-alpha) is important in the pathogenesis of vasculitis and GN in WG.
本研究旨在测定96例日本各种与肾血管炎和血管炎性综合征相关的胶原疾病患者的抗中性粒细胞胞浆抗体（ANCA）水平。结果表明，胞浆型（C）-ANCA是韦格纳肉芽肿（WG）高度特异性的自身抗体，且在肾损伤中也具有活性。研究了ANCA与局灶节段性坏死性肾小球肾炎（即Balow提出的肾血管炎）之间的关系。在无WG的肾血管炎中，核周型（P）-ANCA检测具有高敏感性和特异性，且WG中坏死性和新月体性肾炎的严重程度与C-ANCA滴度尤其密切相关。ANCA检测在肾血管炎的病因鉴别中被认为具有临床实用性，提示C-ANCA可能参与WG中肾小球毛细血管血管炎的发病。C-ANCA和细胞因子（IL-1β和TNF-α）的存在在WG中血管炎和肾小球肾炎的发病机制中具有重要意义。
