Towards precision medicine in ANCA-associated vasculitis

被引：25
作者：
van der Geest, Kornelis S. M. [1 ,2 ]
Brouwer, Elisabeth [1 ,2 ]
Sanders, Jan-Stephan [1 ,3 ]
Sandovici, Maria [1 ,2 ]
Bos, Nicolaas A. [1 ,2 ]
Boots, Annemieke M. H. [1 ,2 ]
Abdulahad, Wayel H. [1 ,2 ]
Stegeman, Coen A. [1 ,3 ]
Kallenberg, Cees G. M. [1 ,2 ]
Heeringa, Peter [1 ,4 ]
Rutgers, Abraham [1 ,2 ]
机构：
[1] Univ Groningen, Univ Med Ctr Groningen, Vasculitis Expertise Ctr Groningen, Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Rheumatol, Groningen, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Nephrol, Groningen, Netherlands
[4] Univ Groningen, Univ Med Ctr Groningen, Dept Pathol & Med Biol, Groningen, Netherlands
来源：
RHEUMATOLOGY | 2018年 / 57卷 / 08期
基金：
欧盟地平线“2020”;
关键词：
disease subsets; vasculitis; ANCA; precision medicine; personalized medicine; ANTIBODY-ASSOCIATED VASCULITIS; ANTINEUTROPHIL CYTOPLASMIC AUTOANTIBODIES; NEUTROPHIL EXTRACELLULAR TRAPS; SMALL-VESSEL VASCULITIS; NECROSIS-FACTOR-ALPHA; WEGENERS-GRANULOMATOSIS; T-CELLS; TREATMENT RESISTANCE; RENAL VASCULITIS; EOSINOPHILIC GRANULOMATOSIS;
D O I：
10.1093/rheumatology/kex367
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
ANCA-associated vasculitis (AAV) is characterized by inflammation and destruction of small and medium-sized vessels. Current management strategies for AAV have been validated in large groups of patients. However, recent insights indicate that distinct patient subsets may actually exist within AAV, thereby justifying the development of more personalized treatment strategies. In this review, we discuss current evidence for a better classification of AAV based on ANCA type. We describe how thus defined categories of AAV patients may differ in genetic background, clinical presentation, immune pathology, response to treatment and disease outcome. We also explore how these insights may provide a rationale for targeted treatments in different categories of AAV patients. Finally, we provide recommendations on how to further establish precision medicine in AAV.
引用
收藏
页码：1332 / 1339
页数：8
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