The kidneys and ANCA-associated vasculitis: from pathogenesis to diagnosis.
The kidneys and ANCA-associated vasculitis: from pathogenesis to diagnosis.
复制标题
DOI：
10.1093/ckj/sfv020
复制
发表时间：
2015-06
影响因子：
4.6
通讯作者：
Klinger M
中科院分区：
文献类型：
--
作者：
Rowaiye OO;Kusztal M;Klinger M
抗中性粒细胞胞浆抗体(ANCA)相关小血管炎(AAV)是一组免疫功能低下的小血管炎，常累及肾脏，表现为急进性肾小球肾炎。虽然AAV的确切发病机制尚不完全清楚，但来自体外、体内和临床研究的证据都表明ANCA参与了AAV的发病。在这篇综述中，我们重点介绍了各种因素(如遗传、环境、B和T调节细胞、Toll样受体等)所起的作用。在甲型肝炎病毒的发病机制中起重要作用。此外，我们从临床特征和不同的组织病理学分类模式方面讨论了AAV的肾脏受累，这也是已知的对预后重要的因素。我们还介绍了在AAV中定位肾脏和其他器官系统受累的有用成像技术的信息，以及有助于快速和更具体地确定患者ANCA状态的新的实验室方法和分析。最后，我们展示了新的血清生物标记物的证据，这些标记物已被证明与AAV的疾病活动相关。
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of pauci-immune small vessel vasculitides that often affect the kidneys manifesting as rapidly progressive glomerulonephritis. Although the exact pathogenesis of AAV is not fully known, evidence from in vitro, in vivo and clinical studies all point to the involvement of ANCA in the pathogenesis of AAV. In this review, we highlight the contributory roles played by various factors (e.g. genetics, environment, B and T-regulatory cells, toll-like receptors, etc.) in the pathogenesis of AAV. Furthermore, we discuss renal involvement in AAV in terms of clinical features and the various histopathological classification patterns, which are also known to be of prognostic importance. We also present information on useful imaging techniques for localizing kidney and other organ system involvement in AAV, and also on novel laboratory methods and assays useful for rapid and more specific determination of patients' ANCA status. Finally, we demonstrate evidence on novel serum biomarkers that have been shown to correlate with disease activity in AAV.