Clinical Immunology and Rheumatology Wing, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Rheum Dis. 2022 Feb;25(2):218-227. doi: 10.1111/1756-185X.14262. Epub 2021 Dec 15.
To study the expression of B cell-activating factor of tumor necrosis factor family (BAFF) and A proliferation-inducing ligand (APRIL) genes in active and remitting patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and healthy controls and their correlation with disease activity.
This was a prospective case-control study. Gene expressions of BAFF and APRIL were studied in 32 patients with AAV (16 each with active disease and in remission) and 30 healthy age and sex matched controls by real-time polymerase chain reaction.
Out of 32 AAV patients, 26 had granulomatosis with polyangiitis (GPA) and 6 had microscopic polyangiitis (MPA). Mean ages of patients in active (12 GPA and 4 MPA) and remission (14 GPA and 2 MPA) groups were 39.4 ± 17.2 and 44.6 ± 16.1 years, respectively. BAFF gene expression was significantly higher in both the active AAV group and remission AAV group compared to controls (P < .01). The BAFF expression was significantly higher in AAV patients in remission compared to active AAV patients (P = .003). In contrast, APRIL expression did not differ between AAV patients and controls (P = .829). However, APRIL had significantly higher expression in remission as compared to active patients (P = .048). There was no significant correlation of both BAFF and APRIL expression with disease activity markers (erythrocyte sedimentation rate, C-reactive protein, platelets and Birmingham Vasculitis Activity Score version 3).
BAFF gene is significantly expressed in patients with AAV. Among AAV patients, there is a significantly higher expression of BAFF and APRIL in remitting state of the disease as compared to active state. There is no significant change in APRIL gene expression in patients with AAV as compared to controls. This makes a case for anti-BAFF therapy in future for AAV patients in northern India.
研究肿瘤坏死因子家族 B 细胞激活因子（BAFF）和增殖诱导配体（APRIL）基因在抗中性粒细胞胞质抗体相关性血管炎（AAV）活动期和缓解期患者及健康对照者中的表达及其与疾病活动度的相关性。
这是一项前瞻性病例对照研究。采用实时聚合酶链反应（PCR）检测 32 例 AAV 患者（活动期 16 例，缓解期 16 例）和 30 名年龄和性别匹配的健康对照者的 BAFF 和 APRIL 基因表达。
32 例 AAV 患者中，26 例为肉芽肿性多血管炎（GPA），6 例为显微镜下多血管炎（MPA）。活动期（12 例 GPA 和 4 例 MPA）和缓解期（14 例 GPA 和 2 例 MPA）患者的平均年龄分别为 39.4±17.2 岁和 44.6±16.1 岁。与对照组相比，活动期和缓解期 AAV 患者的 BAFF 基因表达均显著升高（均 P＜0.01）。缓解期 AAV 患者的 BAFF 表达显著高于活动期 AAV 患者（P=0.003）。相反，AAV 患者与对照组的 APRIL 表达无差异（P=0.829）。然而，缓解期 APRIL 的表达明显高于活动期（P=0.048）。BAFF 和 APRIL 表达与疾病活动标志物（红细胞沉降率、C 反应蛋白、血小板和伯明翰血管炎活动评分 3 版）均无显著相关性。
BAFF 基因在 AAV 患者中表达明显。在 AAV 患者中，与活动期相比，缓解期的 BAFF 和 APRIL 表达明显更高。与对照组相比，AAV 患者的 APRIL 基因表达无明显变化。这为印度北部的 AAV 患者未来使用抗 BAFF 治疗提供了依据。
