Plasma levels of soluble interleukin 2 receptor, soluble CD30, interleukin 10 and B cell activator of the tumour necrosis factor family during follow-up in vasculitis associated with proteinase 3-antineutrophil cytoplasmic antibodies: associations with disease activity and relapse

Ann Rheum Dis. 2006 Nov;65(11):1484-9. doi: 10.1136/ard.2005.046219. Epub 2006 Feb 27.

Abstract

Objectives: To evaluate whether T cell activation, as reflected by levels of soluble interleukin 2 receptor (sIL2R), soluble CD30 (sCD30), IL-10 and B cell activator of the tumour necrosis factor family (BAFF) at diagnosis and during initial follow-up, is predictive for persistent or renewed antineutrophil cytoplasmic antibody (ANCA) positivity and clinical relapse in patients with vasculitis associated with proteinase 3-antineutrophil cytoplasmic antibodies (PR3-ANCA).

Methods: 87 Patients with PR3-ANCA-associated vasculitis and at least 2 years of follow-up were included in the study. At diagnosis, and at 3, 6, 12, 18 and 24 months after diagnosis, cytoplasmic ANCA titres were detected by indirect immunofluorescence (IIF), and PR3-ANCA, sIL2R, sCD30, IL-10 and BAFF levels were assessed by ELISA. 31 healthy volunteers provided plasma samples for comparison. Levels of immune markers were related to ANCA positivity and relapse during follow-up.

Results: Plasma levels of sIL2R, sCD30 and BAFF were higher in patients than in controls at all time points. Plasma levels of sIL2R, sCD30 and IL-10 were higher at diagnosis and relapse than during remission. At 18 months, sCD30 (p<0.001) and sIL2R levels (p = 0.01) were significantly higher in PR3-ANCA-positive patients (detected by ELISA) than in PR3-ANCA-negative patients. ANCA-positive patients detected by ELISA or IIF at 24 months had significantly higher plasma sCD30 levels (p = 0.02 and p = 0.03, respectively) than ANCA-negative patients.

Conclusion: Increased T cell activation in patients with ANCA-associated vasculitis in remission during and after immunosuppressive treatment is associated with persistent or renewed ANCA positivity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • B-Cell Activating Factor
  • Biomarkers / blood
  • Cyclophosphamide / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interleukin-10 / blood
  • Ki-1 Antigen / blood
  • Lymphocyte Activation / immunology*
  • Male
  • Membrane Proteins / blood
  • Middle Aged
  • Myeloblastin
  • Prednisolone / therapeutic use
  • Receptors, Interleukin-2 / blood
  • Retrospective Studies
  • Serine Endopeptidases / immunology
  • Severity of Illness Index
  • Solubility
  • T-Lymphocytes / immunology*
  • Tumor Necrosis Factor-alpha
  • Vasculitis / drug therapy
  • Vasculitis / immunology*

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • B-Cell Activating Factor
  • Biomarkers
  • Glucocorticoids
  • Immunosuppressive Agents
  • Ki-1 Antigen
  • Membrane Proteins
  • Receptors, Interleukin-2
  • TNFSF13B protein, human
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Cyclophosphamide
  • Prednisolone
  • Serine Endopeptidases
  • Myeloblastin