医学
血管炎
内科学
ANCA相关性血管炎
免疫学
显微镜下多血管炎
抗中性粒细胞胞浆抗体
肉芽肿伴多发性血管炎
系统性血管炎
胃肠病学
作者
Kotaro Matsumoto,Katsuya Suzuki,Keiko Yoshimoto,Noriyasu Seki,Hideto Tsujimoto,Kenji Chiba,Tsutomu Takeuchi
出处
期刊:Rheumatology
[Oxford University Press]
日期:2019-08-03
卷期号:59 (3): 545-553
被引量:9
标识
DOI:10.1093/rheumatology/kez327
摘要
Objectives To elucidate the association between clinical characteristics and immuno-phenotypes in patients with ANCA-associated vasculitis (AAV). Methods Peripheral blood from 36 patients with active AAV and 18 healthy controls was examined for numbers of circulating T cells, B cells, NK cells, dendritic cells, monocytes and granulocytes using flow cytometry. These immuno-phenotyping data were subjected to cluster analysis and principal components analysis to divide AAV patients into subgroups. Associated organ involvement or therapeutic prognosis were assessed for each subgroup. Results AAV patients had higher proportions of plasma cells, plasmablasts, activated T cells, CD14++ CD16+ monocytes, eosinophils and neutrophils than healthy controls. Immuno-phenotyping findings were similar between patients with microscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis. Cluster analysis indicated that AAV patients could be divided into three subgroups according to peripheral immune cell numbers: antibody production-related (n = 9), cytotoxic activity-related (n = 4) and neutrocytosis/lymphocytopenia-related (n = 23). The antibody production-related or cytotoxic activity-related group was associated with CNS involvement, and the neutrocytosis/lymphocytopenia-related group was associated with high incidence of kidney involvement. Incidence of severe infection was markedly higher in the neutrocytosis/lymphocytopenia-related group than the other two groups. Incidence of disease relapse was comparable among the three groups. Conclusion Patients with active AAV can be divided into three subgroups based on immuno-phenotyping. These results may provide a hint to understanding disease pathophysiology and prognosis, and determining appropriate treatment.
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