�The discovery of "complementary" antibodies against plasminogen in patients with blood watercraft inflammation caused by anti-neutrophil cytoplasmic autoantibodies (ANCAs) may lead to new approaches to inquiry, testing, and treatment of ANCA vasculitis and other autoimmune diseases, suggests a paper in the December Journal of the American Society of Nephrology (JASN).
"This research is especially important because it opens new avenues for exploration of autoimmune disease that embrace the concepts of protein complementarity," comments Ronald J. Falk, MD, of UNC Kidney Center, University of North Carolina, Chapel Hill, one of the authors of the study. "The power of this approach has gone unappreciated, even though the basic ideas of protein complementarity induce been proven in other settings over the years."
The researchers looked for complemental proteins in a grouping of patients with a rare autoimmune disease called ANCA vasculitis. People with autoimmune diseases have abnormal "autoantibodies" that cause the immune system to flack the body's own cells and tissues. In patients with ANCA vasculitis, the ANCAs approach a character of theodore Harold White blood cells called neutrophils, which in turn approach the blood vessel walls. The resulting blood vessel inflammation (vasculitis) can lead to kidney damage (glomerulonephritis) and other complications.
The patients in the study had a particularly aggressive form of vasculitis caused by ANCAs against a protein called PR3. They were being treated with a procedure called plasma exchange therapy (or plasmapheresis), which removes the PR3 ANCAs from the blood. "Using an antibody reactive with complementary PR3 protein, produced in the laboratory, we analyzed protein pools removed from the patients' blood plasma during plasma exchange therapy to name any existing proteins that were reactive with the anti-complementary PR3 antibody," Dr. Falk explains. Previous studies have suggested that antibodies to complementary proteins english hawthorn play an important role in the initiation of autoimmune diseases.
The results showed autoantibodies to a complementary protein that, to the researchers' surprisal, turned extinct to be plasminogen a protein that plays a key role in blood line clotting. 22% of the patients with PR3 ANCA vasculitis had anti-plasminogen antibodies, including 56% of those who had serious blood coagulation problems as a complication of their disease. "Identification of potentially pathogenic [disease-causing] anti-plasminogen antibodies provides an explanation of why patients with PR3-ANCA disease have a high incidence of blood clots," says Dr. Falk.
The results may have important implications for the care of patients with ANCA vasculitis most immediately, in identifying those at high risk of exposure of development blood clots. However, the assay ill-used in the study was inadequate for clinical utilisation. "What is needed is a clinical test that is specific and precise enough to measure anti-plasminogen antibody levels," adds Dr. Falk. Further studies will be needful to make the clinical value of such a test, including the correlational statistics between complementary antibody levels and the risk of blood clots.
In addition, the study suggests that complementary antibodies crataegus oxycantha play a more authoritative role in autoimmune diseases than scientists have antecedently realized. The methods used may tether to the discovery of autoantibodies to complementary proteins in other autoimmune diseases for exercise, rheumatoid arthritis or multiple sclerosis. "Hopefully, our discoveries will tempt scientists to consider the potential implications of protein complementarity," says Dr. Falk.
This research was supported by National Institutes of Health grant 2P01 DK058335.
The clause, entitled "Antibodies with Dual Reactivity to Plasminogen and Complementary PR3 in PR3-ANCA Vasculitis," volition appear on-line at hTTP://jasn.asnjournals.org on Wednesday, August 13, 2008, and in the December 2008 print issue of JASN.
ASN is a not-for-profit organization of 11,000 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of info regarding the latest research and clinical findings on kidney diseases. ASN publishes JASN, the Clinical Journal of the American Society of Nephrology (CJASN), and the Nephrology Self-Assessment Program (NephSAP). In January 2009, the Society will plunge ASN Kidney News, a newsmagazine for nephrologists, scientists, allied wellness professionals, and staff.
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