Pathogenesis and treatment of ANCA-associated vasculitides

被引:0
作者
Kallenberg, C. G. M. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Rheumatol & Clin Immunol, NL-9700 RB Groningen, Netherlands
关键词
ANCA-associated vasculitis; MPO-ANCA; PR3-ANCA; pathogenesis; treatment; RITUXIMAB; CYCLOPHOSPHAMIDE; REMISSION;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Recent studies have increased our insight into the pathogenesis of ANCA-associated vasculitis (AAV). Although many data from in vitro and in vivo experimental studies support the pathogenic role of the autoantibodies, cellular immunity seems involved as well. Besides, an amplification loop via the alternative pathway of complement is apparent. These new insights make a more targeted therapeutic approach possible. In particular, the B-cell depleting antibody rituximab has been shown non-inferior to cyclophosphamide for induction of remission, and even superior in patients with relapsing disease being positive for PR3-ANCA. Rituximab is also superior to cyclophosphamide for maintaining remission. Blocking the C5a-receptor seems promising as well as an alternative for high dose corticosteroids during induction of remission.
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页码:S11 / S14
页数:4
相关论文
共 22 条
[1]   T-helper cells as new players in ANCA-associated vasculitides [J].
Abdulahad, Wayel H. ;
Lamprecht, Peter ;
Kallenberg, Cees G. M. .
ARTHRITIS RESEARCH & THERAPY, 2011, 13 (04)
[2]   Neonatal microscopic polyangiitis secondary to transfer of maternal myeloperoxidase-antineutrophil cytoplasmic antibody resulting in neonatal pulmonary hemorrhage and renal involvement [J].
Bansal, PJ ;
Tobin, MC .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2004, 93 (04) :398-401
[3]   Sialylation Levels of Anti-Proteinase 3 Antibodies Are Associated With the Activity of Granulomatosis With Polyangiitis (Wegener's) [J].
Espy, Cecile ;
Morelle, Willy ;
Kavian, Niloufar ;
Grange, Philippe ;
Goulvestre, Claire ;
Viallon, Vivian ;
Chereau, Christiane ;
Pagnoux, Christian ;
Michalski, Jean-Claude ;
Guillevin, Loic ;
Weill, Bernard ;
Batteux, Frederic ;
Guilpain, Philippe .
ARTHRITIS AND RHEUMATISM, 2011, 63 (07) :2105-2115
[4]   Rituximab versus Azathioprine for Maintenance in ANCA-Associated Vasculitis [J].
Guillevin, L. ;
Pagnoux, C. ;
Karras, A. ;
Khouatra, C. ;
Aumaitre, O. ;
Cohen, P. ;
Maurier, F. ;
Decaux, O. ;
Ninet, J. ;
Gobert, P. ;
Quemeneur, T. ;
Blanchard-Delaunay, C. ;
Godmer, P. ;
Puechal, X. ;
Carron, P. -L. ;
Hatron, P. -Y. ;
Limal, N. ;
Hamidou, M. ;
Ducret, M. ;
Daugas, E. ;
Papo, T. ;
Bonnotte, B. ;
Mahr, A. ;
Ravaud, P. ;
Mouthon, L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2014, 371 (19) :1771-1780
[5]   2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides [J].
Jennette, J. C. ;
Falk, R. J. ;
Bacon, P. A. ;
Basu, N. ;
Cid, M. C. ;
Ferrario, F. ;
Flores-Suarez, L. F. ;
Gross, W. L. ;
Guillevin, L. ;
Hagen, E. C. ;
Hoffman, G. S. ;
Jayne, D. R. ;
Kallenberg, C. G. M. ;
Lamprecht, P. ;
Langford, C. A. ;
Luqmani, R. A. ;
Mahr, A. D. ;
Matteson, E. L. ;
Merkel, P. A. ;
Ozen, S. ;
Pusey, C. D. ;
Rasmussen, N. ;
Rees, A. J. ;
Scott, D. G. I. ;
Specks, U. ;
Stone, J. H. ;
Takahashi, K. ;
Watts, R. A. .
ARTHRITIS AND RHEUMATISM, 2013, 65 (01) :1-11
[6]   Complement in ANCA-Associated Vasculitis [J].
Jennette, J. Charles ;
Xiao, Hong ;
Hu, Peiqi .
SEMINARS IN NEPHROLOGY, 2013, 33 (06) :557-564
[7]   Rituximab versus Cyclophosphamide in ANCA-Associated Renal Vasculitis. [J].
Jones, Rachel B. ;
Tervaert, Jan Willem Cohen ;
Hauser, Thomas ;
Luqmani, Raashid ;
Morgan, Matthew D. ;
Peh, Chen Au ;
Savage, Caroline O. ;
Segelmark, Marten ;
Tesar, Vladimir ;
van Paassen, Pieter ;
Walsh, Dorothy ;
Walsh, Michael ;
Westman, Kerstin ;
Jayne, David R. W. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (03) :211-220
[8]   Key advances in the clinical approach to ANCA-associated vasculitis [J].
Kallenberg, Cees G. M. .
NATURE REVIEWS RHEUMATOLOGY, 2014, 10 (08) :484-493
[9]   Pathogenesis of ANCA-Associated Vasculitis: New Possibilities for Intervention [J].
Kallenberg, Cees G. M. ;
Stegeman, Coen A. ;
Abdulahad, Wayel H. ;
Heeringa, Peter .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2013, 62 (06) :1176-1187
[10]   Churg-Strauss syndrome: Just one disease entity? [J].
Kallenberg, CGM .
ARTHRITIS AND RHEUMATISM, 2005, 52 (09) :2589-2593