Traditional approaches and new opportunities in treatment of ANCA-associated vasculitis. Clinical examples
Abstract
ANCA-associated vasculitis is a group of autoimmune diseases affecting small caliber vessels with the development of necrotizing vasculitis, which are characterized by a diverse clinical picture with the involvement of the inflammatory process of vital organs - lungs, kidneys, upper respiratory tract, central nervous system, gastrointestinal tract - and with a serious prognosis. The treatment of ANCA-CB includes therapy with corticosteroids, cytostatics, monoclonal antibodies. However, with the development of life-threatening conditions (hemoptysis, pulmonary bleeding, cerebrovascular) aferente treatments are used, i.e. herapeutic plasma exchange, therapeutic plasmapheresis (TPE) and double filtration plasmapheresis (DFPP).
About the Authors
M. S. Vetsheva
First Moscow State Medical University n.a. I. M. Sechenov
Russian Federation
Russian Federation
K. E. Loss
City Clinical Hospital No. 13; Moscow
Russian Federation
Russian Federation
O. L. Podkorytova
City Clinical Hospital No. 13; Moscow
Russian Federation
Russian Federation
E. N. Dyakova
City Clinical Hospital No. 13; Moscow
Russian Federation
Russian Federation
References
1. Jennette J. Overview of the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Clin Exp Nephrol. 2013 Oct; 17 (5): 603-606.
2. Van Daalen E., Ferrario F., Noël L. H., Waldherr R. Hagen E. C., Bruijn J. A., Bajema I.M.: Twenty-five years of RENHIS: a history of histopathological studies within EUVAS / van Daalen E., Ferrario F., Noël L. H., Waldherr R. Hagen E. C., Bruijn J. A., Bajema I. M. // Nephrol. Dial. Transplant.- 2015. -30.- Р. 31-36.
3. Yates M, Watts RA, Bajema IM, et al. EULAR/ ERA-EDTA recommendations for the management of ANCA-associated vasculitis. Ann Rheum Dis. 2016 Jun 23. pii: annrheum-dis-2016-209133. doi: 10.1136/annrheum-dis-2016-209133.
4. Watts RA, Lane SE, Bentham G, Scott DGI Epidemiology of systemic vasculitis - a 10 year study.- Arthritis Rheum 2000; 43: 422-427.
5. Fujimoto S, Watts R, Kobayashi S, et al. Comparison of the epidemiology of anti-neutrophil cytoplasmic antibodyassociated vasculitis between Japan and the UK. - Rheumatology 2011; 50: 1916-1920.
6. Бекетова Т.В. АНЦА-ассоциированный системный васкулит. Нефрология. Национальное руководство / гл. ред. Н. А. Мухин.- М.: ГЭОТАР-Медиа, 2014.
7. Manno L. et al. Older patients with ANCA-associated vasculitis and dialysis dependent renal failure: a retrospective study.- BMC Nephrology 2015. 16:88. DOI: 10.1186/ sl2882-015-0082-9.
8. Hilhorst М. et al. Connective tissue growth factor and the cicatrization of cellular crescents in ANCA-associated glomerulonephritis.- NDT. Volume 30, Issue 8. Pp. 1291-1299.
9. Jeffrey L. Winters. Plasma exchange: concepts, mechanisms, and an overview of the American Society for Apheresis guidelines.- American Society of Hematology. Hematology 2012. 7-12.
10. Falk R. J., Terrell R. S., Charles L. A. & Jennette J. C. Anti-neutrophil cytoplasmic autoantibodies induce neutrophils to degranulate and produce oxygen radicals in vitro.- Proc. Natl Acad. Sci. USA 87, 41154119 (1990).
11. Ewert B. H., Becker M.E., Jennette J. C. & Falk R. J. Antimyeloperoxidase antibodies induce neutrophil adherence to cultured human endothelial cells.- Ren. Fail. 17, 125-133 (1995).
12. Van der Woude F., Rasmussen N., Lobatto S. et al. Autoantibodies against neutrophils and monocytes: tool for diagnosis and marker of disease activity in Wegener’s granulomatosis.- Lancet 1985; 1: 425-9.
13. Falk R. J., Terrell R. S., Charles L. A. & Jennette J. C. Anti-neutrophil cytoplasmic autoantibodies induce neutrophils to degranulate and produce oxygen radicals in vitro.- Proc. Natl Acad. Sci. USA 87, 41154119 (1990).
14. Roth A.J. et al. Anti-LAMP-2 antibodies are not prevalent in patients with antineutrophil cytoplasmic autoantibody glomerulonephritis.- J. Am. Soc. Nephrol. 23, 545-555 (2012).
15. Berden et al. Histopathologic classification of ANCA-associated glomerulonephritis.- J Am Soc Nephrol. 2010 Oct; 21 (10): 1628-36. doi: 10.1681/ASN.2010050477. Epub 2010 Jul 8.
16. Kallenberg CG et al. Pathogenesis of ANCA-associated vasculitis: new possibilities for intervention.-Am J Kidney Dis. 2013 Dec; 62 (6): 1176-87. doi: 10.1053/j.ajkd.2013.05.009. Epub 2013 Jun 28.
17. Luqmani R. Birmingham Vasculitis Activity Score (BVAS) in systemic necrotizing vasculitis / Luqmani R, Bacon P, Moots R, Janssen B, et al. // QJM. -1994.- 87.- Р. 671-678.
18. Taylor SR, Salama AD, Joshi L, Pusey CD, Lightman SL. Rituximab is effective in the treatment of refractory ophthalmic Wegener’s granulomatosis / Taylorn SR, Salama AD, Joshi L, Pusey CD, Lightman SL. // Arthritis Rheum. - 2009.- 60.- 5.- Р. 1540-1547.
19. Walsh M, Casian A, Flossmann O et al. Long-term follow-up of patients with severe ANCA-associated vasculitis comparing plasma exchange to intravenous methylprednisolone treatment is unclear. Kidney Int 2013; 84: 397-402.
20. Ward DM, Conventional apheresis therapies: a review.- J Clin Apher. 2011; 26 (5): 230-8. doi: 10.1002/jca.20302. Epub 2011 Aug 31.
21. Jayne DRW, Gaskin G, Rasmussen N, et al. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis.- J Am Soc Nephrol 2007; 18: 2180-2188.
Review
For citations:
Vetsheva M.S., Loss K.E., Podkorytova O.L., Dyakova E.N. Traditional approaches and new opportunities in treatment of ANCA-associated vasculitis. Clinical examples. Medical alphabet. 2018;2(18):35-42. (In Russ.)
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