Pathogenesis of Pulmonary Manifestations in ANCA-Associated Vasculitis and Goodpasture Syndrome

Int J Mol Sci. 2024 May 12;25(10):5278. doi: 10.3390/ijms25105278.

Abstract

Pulmonary manifestations of vasculitis are associated with significant morbidity and mortality in affected individuals. They result from a complex interplay between immune dysregulation, which leads to vascular inflammation and tissue damage. This review explored the underlying pathogenesis of pulmonary involvement in vasculitis, encompassing various forms such as granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), eosinophilic granulomatosis with polyangiitis (EGPA), and anti-GBM disease. Mechanisms involving ANCA and anti-GBM autoantibodies, neutrophil activation, and neutrophil extracellular trap (NETs) formation are discussed, along with the role of the complement system in inducing pulmonary injury. Furthermore, the impact of genetic predisposition and environmental factors on disease susceptibility and severity was considered, and the current treatment options were presented. Understanding the mechanisms involved in the pathogenesis of pulmonary vasculitis is crucial for developing targeted therapies and improving clinical outcomes in affected individuals.

Keywords: ANCA-associated vasculitis; lung; pathogenesis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Glomerular Basement Membrane Disease* / etiology
  • Anti-Glomerular Basement Membrane Disease* / immunology
  • Anti-Glomerular Basement Membrane Disease* / pathology
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / immunology
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / pathology
  • Antibodies, Antineutrophil Cytoplasmic / immunology
  • Autoantibodies / immunology
  • Extracellular Traps / immunology
  • Extracellular Traps / metabolism
  • Humans
  • Lung / immunology
  • Lung / pathology
  • Lung Diseases / etiology
  • Lung Diseases / immunology
  • Lung Diseases / pathology
  • Microscopic Polyangiitis / complications
  • Microscopic Polyangiitis / immunology
  • Microscopic Polyangiitis / pathology

Substances

  • Antibodies, Antineutrophil Cytoplasmic
  • Autoantibodies

Grants and funding

This research received no external funding.