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Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis

OBJECTIVE: To investigate the mechanisms of vasculitis in nonsystemic vasculitic neuropathy (NSVN) and microscopic polyangiitis (MPA), focusing on complement- and antineutrophil cytoplasmic antibody (ANCA)-associated pathogenesis. METHODS: Sural nerve biopsy specimens taken from twenty-four patients...

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Autores principales: Takahashi, Mie, Koike, Haruki, Ikeda, Shohei, Kawagashira, Yuichi, Iijima, Masahiro, Hashizume, Atsushi, Katsuno, Masahisa, Sobue, Gen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656408/
https://www.ncbi.nlm.nih.gov/pubmed/29082297
http://dx.doi.org/10.1212/NXI.0000000000000407
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author Takahashi, Mie
Koike, Haruki
Ikeda, Shohei
Kawagashira, Yuichi
Iijima, Masahiro
Hashizume, Atsushi
Katsuno, Masahisa
Sobue, Gen
author_facet Takahashi, Mie
Koike, Haruki
Ikeda, Shohei
Kawagashira, Yuichi
Iijima, Masahiro
Hashizume, Atsushi
Katsuno, Masahisa
Sobue, Gen
author_sort Takahashi, Mie
collection PubMed
description OBJECTIVE: To investigate the mechanisms of vasculitis in nonsystemic vasculitic neuropathy (NSVN) and microscopic polyangiitis (MPA), focusing on complement- and antineutrophil cytoplasmic antibody (ANCA)-associated pathogenesis. METHODS: Sural nerve biopsy specimens taken from twenty-four patients with NSVN and 37 with MPA-associated neuropathy (MPAN) were examined. Twenty-two patients in the MPAN group tested positive for ANCA. RESULTS: Immunostaining for complement component C3d deposition showed more frequent positive staining of epineurial small vessels in NSVN than in MPAN (p = 0.002). The percentages of C3d-positive blood vessels were higher in the NSVN group than those in the ANCA-positive MPAN and ANCA-negative MPAN groups (p = 0.002 and p = 0.009, respectively). Attachment of neutrophils to the endothelial cells of epineurial small vessels was frequently observed in the MPAN groups, irrespective of the presence or absence of ANCA, but was scarce in the NSVN group. Immunohistochemistry using antimyeloperoxidase (MPO) antibodies revealed that the number of MPO-positive cells attached to the endothelial cells of epineurial vessels was lower in the NSVN group than that in the ANCA-positive MPAN and ANCA-negative MPAN groups (p < 0.001 and p = 0.011, respectively). CONCLUSIONS: NSVN and MPA have distinct mechanisms of vasculitis. In MPA, the attachment of neutrophils to vascular endothelial cells seems to be an initial lesion of vasculitis, regardless of the presence or absence of ANCA. Complement participated in the pathogenesis of vasculitis in NSVN.
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spelling pubmed-56564082017-10-27 Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis Takahashi, Mie Koike, Haruki Ikeda, Shohei Kawagashira, Yuichi Iijima, Masahiro Hashizume, Atsushi Katsuno, Masahisa Sobue, Gen Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: To investigate the mechanisms of vasculitis in nonsystemic vasculitic neuropathy (NSVN) and microscopic polyangiitis (MPA), focusing on complement- and antineutrophil cytoplasmic antibody (ANCA)-associated pathogenesis. METHODS: Sural nerve biopsy specimens taken from twenty-four patients with NSVN and 37 with MPA-associated neuropathy (MPAN) were examined. Twenty-two patients in the MPAN group tested positive for ANCA. RESULTS: Immunostaining for complement component C3d deposition showed more frequent positive staining of epineurial small vessels in NSVN than in MPAN (p = 0.002). The percentages of C3d-positive blood vessels were higher in the NSVN group than those in the ANCA-positive MPAN and ANCA-negative MPAN groups (p = 0.002 and p = 0.009, respectively). Attachment of neutrophils to the endothelial cells of epineurial small vessels was frequently observed in the MPAN groups, irrespective of the presence or absence of ANCA, but was scarce in the NSVN group. Immunohistochemistry using antimyeloperoxidase (MPO) antibodies revealed that the number of MPO-positive cells attached to the endothelial cells of epineurial vessels was lower in the NSVN group than that in the ANCA-positive MPAN and ANCA-negative MPAN groups (p < 0.001 and p = 0.011, respectively). CONCLUSIONS: NSVN and MPA have distinct mechanisms of vasculitis. In MPA, the attachment of neutrophils to vascular endothelial cells seems to be an initial lesion of vasculitis, regardless of the presence or absence of ANCA. Complement participated in the pathogenesis of vasculitis in NSVN. Lippincott Williams & Wilkins 2017-10-23 /pmc/articles/PMC5656408/ /pubmed/29082297 http://dx.doi.org/10.1212/NXI.0000000000000407 Text en Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Takahashi, Mie
Koike, Haruki
Ikeda, Shohei
Kawagashira, Yuichi
Iijima, Masahiro
Hashizume, Atsushi
Katsuno, Masahisa
Sobue, Gen
Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title_full Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title_fullStr Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title_full_unstemmed Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title_short Distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
title_sort distinct pathogenesis in nonsystemic vasculitic neuropathy and microscopic polyangiitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656408/
https://www.ncbi.nlm.nih.gov/pubmed/29082297
http://dx.doi.org/10.1212/NXI.0000000000000407
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