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Research ArticleVasculitis

Microparticles Expressing Myeloperoxidase and Complement C3a and C5a as Markers of Renal Involvement in Antineutrophil Cytoplasmic Antibody–associated Vasculitis

Aleksandra Antovic, Fariborz Mobarrez, Milena Manojlovic, Nida Soutari, Victoria De Porta Baggemar, Annica Nordin, Annette Bruchfeld, Jelena Vojinovic and Iva Gunnarsson
The Journal of Rheumatology May 2020, 47 (5) 714-721; DOI: https://doi.org/10.3899/jrheum.181347
Aleksandra Antovic
From the Division of Rheumatology, Department of Medicine, Department of Molecular Medicine and Surgery, Clinical Chemistry, and Renal Medicine, Karolinska Institutet; Rheumatology, Karolinska University Hospital; CLINTEC Karolinska University Hospital, Renal Medicine, Karolinska Institutet, Stockholm; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Pediatrics, Medical Faculty, University of Niš, Niš, Serbia.
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  • For correspondence: aleksandra.antovic@ki.se
Fariborz Mobarrez
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Milena Manojlovic
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Nida Soutari
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Victoria De Porta Baggemar
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Annica Nordin
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Annette Bruchfeld
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Jelena Vojinovic
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Iva Gunnarsson
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Abstract

Objective. To investigate expression of terminal complement components C3a and C5a on circulating myeloperoxidase (MPO)-positive microparticles (MPO+MP) in relation to disease activity and renal involvement in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods. Forty-six clinically well-characterized patients with AAV and 23 age- and sex-matched healthy controls were included. The concentration of MPO+MP expressing C3a and C5a was analyzed from citrate plasma by flow cytometry. Serum levels of C3a and C5a were determined using commercial ELISA. The assessment of vasculitis disease activity was performed using the Birmingham Vasculitis Activity Score (BVAS). Among patients, 23 had active disease with BVAS ≥ 2 and 14 patients had active renal flares.

Results. AAV patients had significantly increased expression of C3a and C5a on MPO+MP compared to controls (both p < 0.0001). When the group of patients with active AAV was divided according to the presence of renal activity, the concentration of MPO+MP expressing C3a and C5a was significantly higher in patients with renal involvement compared to patients with nonrenal disease and controls (p < 0.05 and p < 0.01, respectively). The serum levels of C3a were significantly decreased (p < 0.01) in the renal subgroup, while there were no changes in serum levels of C5a comparing the renal and nonrenal groups. There was significant correlation between the disease activity measured by BVAS and the levels of C3a and C5a expressed on MPO+MP.

Conclusion. Determination of C3a and C5a on MPO+MP might be considered as a novel biomarker of renal involvement in patients with AAV and may be of importance in the pathogenetic process.

Key Indexing Terms:
  • ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS
  • COMPLEMENT
  • MICROPARTICLES

Footnotes

  • This study was performed with the help of ALF funding from Stockholm County Council and Karolinska Institutet, Gustav V’s 80-year Foundation, and the Swedish Rheumatism Association.

  • Accepted for publication July 8, 2019.
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The Journal of Rheumatology
Vol. 47, Issue 5
1 May 2020
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Microparticles Expressing Myeloperoxidase and Complement C3a and C5a as Markers of Renal Involvement in Antineutrophil Cytoplasmic Antibody–associated Vasculitis
Aleksandra Antovic, Fariborz Mobarrez, Milena Manojlovic, Nida Soutari, Victoria De Porta Baggemar, Annica Nordin, Annette Bruchfeld, Jelena Vojinovic, Iva Gunnarsson
The Journal of Rheumatology May 2020, 47 (5) 714-721; DOI: 10.3899/jrheum.181347

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Microparticles Expressing Myeloperoxidase and Complement C3a and C5a as Markers of Renal Involvement in Antineutrophil Cytoplasmic Antibody–associated Vasculitis
Aleksandra Antovic, Fariborz Mobarrez, Milena Manojlovic, Nida Soutari, Victoria De Porta Baggemar, Annica Nordin, Annette Bruchfeld, Jelena Vojinovic, Iva Gunnarsson
The Journal of Rheumatology May 2020, 47 (5) 714-721; DOI: 10.3899/jrheum.181347
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Keywords

ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS
COMPLEMENT
MICROPARTICLES

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  • antineutrophil cytoplasmic antibody-associated vasculitis
  • COMPLEMENT
  • MICROPARTICLES

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