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ANCA Status or Clinical Phenotype — What Counts More?

PURPOSE OF REVIEW: There is ongoing debate concerning the classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. That is, whether classification should be based on the serotype (proteinase 3 (PR3)- or myeloperoxidase (MPO)-ANCA) or on the clinical phenotype (granulomatos...

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Autores principales: Windpessl, Martin, Bettac, Erica L., Gauckler, Philipp, Shin, Jae Il, Geetha, Duvuru, Kronbichler, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081707/
https://www.ncbi.nlm.nih.gov/pubmed/33909191
http://dx.doi.org/10.1007/s11926-021-01002-0
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author Windpessl, Martin
Bettac, Erica L.
Gauckler, Philipp
Shin, Jae Il
Geetha, Duvuru
Kronbichler, Andreas
author_facet Windpessl, Martin
Bettac, Erica L.
Gauckler, Philipp
Shin, Jae Il
Geetha, Duvuru
Kronbichler, Andreas
author_sort Windpessl, Martin
collection PubMed
description PURPOSE OF REVIEW: There is ongoing debate concerning the classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. That is, whether classification should be based on the serotype (proteinase 3 (PR3)- or myeloperoxidase (MPO)-ANCA) or on the clinical phenotype (granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA)). To add clarity, this review focused on integration of the most recent literature. RECENT FINDINGS: Large clinical trials have provided evidence that a serology-based risk assessment for relapses is more predictive than distinction based on the phenotype. Research conducted in the past decade indicated that a serology-based approach more closely resembles the genetic associations, the clinical presentation (i.e., lung involvement), biomarker biology, treatment response, and is also predicting comorbidities (such as cardiovascular death). SUMMARY: Our review highlights that a serology-based approach could replace a phenotype-based approach to classify ANCA-associated vasculitides. In future, clinical trials and observational studies will presumably focus on this distinction and, as such, translate into a “personalized medicine.”
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spelling pubmed-80817072021-05-05 ANCA Status or Clinical Phenotype — What Counts More? Windpessl, Martin Bettac, Erica L. Gauckler, Philipp Shin, Jae Il Geetha, Duvuru Kronbichler, Andreas Curr Rheumatol Rep Vasculitis (C Dejaco and C Duftner, Section Editors) PURPOSE OF REVIEW: There is ongoing debate concerning the classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. That is, whether classification should be based on the serotype (proteinase 3 (PR3)- or myeloperoxidase (MPO)-ANCA) or on the clinical phenotype (granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA)). To add clarity, this review focused on integration of the most recent literature. RECENT FINDINGS: Large clinical trials have provided evidence that a serology-based risk assessment for relapses is more predictive than distinction based on the phenotype. Research conducted in the past decade indicated that a serology-based approach more closely resembles the genetic associations, the clinical presentation (i.e., lung involvement), biomarker biology, treatment response, and is also predicting comorbidities (such as cardiovascular death). SUMMARY: Our review highlights that a serology-based approach could replace a phenotype-based approach to classify ANCA-associated vasculitides. In future, clinical trials and observational studies will presumably focus on this distinction and, as such, translate into a “personalized medicine.” Springer US 2021-04-28 2021 /pmc/articles/PMC8081707/ /pubmed/33909191 http://dx.doi.org/10.1007/s11926-021-01002-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Vasculitis (C Dejaco and C Duftner, Section Editors)
Windpessl, Martin
Bettac, Erica L.
Gauckler, Philipp
Shin, Jae Il
Geetha, Duvuru
Kronbichler, Andreas
ANCA Status or Clinical Phenotype — What Counts More?
title ANCA Status or Clinical Phenotype — What Counts More?
title_full ANCA Status or Clinical Phenotype — What Counts More?
title_fullStr ANCA Status or Clinical Phenotype — What Counts More?
title_full_unstemmed ANCA Status or Clinical Phenotype — What Counts More?
title_short ANCA Status or Clinical Phenotype — What Counts More?
title_sort anca status or clinical phenotype — what counts more?
topic Vasculitis (C Dejaco and C Duftner, Section Editors)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081707/
https://www.ncbi.nlm.nih.gov/pubmed/33909191
http://dx.doi.org/10.1007/s11926-021-01002-0
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