Serum ANCA and Overall Mortality: A 10-Year Retrospective Cohort Study on 1,024 Italian Subjects

Frontiers in Immunology

Claudio Angelini¹  Emanuela Morenghi¹  Marco Folci¹  Elena Vanni¹  Enrico Brunetta¹  Raffaello Furlan¹  Giacomo Ramponi²  Elena Bredi²  Carlo Selmi³  Maria De Santis³ 

[1] Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy;IRCCS Humanitas Research Hospital, Rozzano, Italy;Unit of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Italy;

关键词: ANCA;    retrospective;    cohort;    vasculitis;    rheumatoid arthritis;   

DOI  :  10.3389/fimmu.2021.714174

来源: DOAJ

【 摘 要 】

BackgroundAntineutrophil cytoplasmic antibodies (ANCA) are primarily involved in the pathogenesis of ANCA-associated vasculitides (AAV). However, ANCA may also be present in healthy subjects and in patients with autoimmune disorders different from AAV. We hypothesized that serum ANCA are associated with a worse prognosis in disorders other than AAV.ObjectiveWe investigated the association between the overall survival and the presence of serum ANCA in 1,024 Italian subjects with various testing indications in a 10-year interval.MethodsIn this retrospective cohort study, a population of 6,285 patients (many of whom were subsequently excluded due to our criteria) who tested for ANCA at a single center in 10 years was considered, and life status and comorbidities of subjects were collected. We compared the overall survival of ANCA-positive and ANCA-negative patients by means of Kaplan-Meier curves, while a multivariable adjusted Cox regression was used to evaluate the association between the ANCA status and the outcome (death) in terms of hazard ratios (HR) with 95% confidence intervals (CI).ResultsThe positivity of perinuclear ANCA (pANCA) increased significantly mortality (HR, 1.60; 95% CI, 1.10–2.32), while cytoplasmic ANCA (cANCA) positivity failed to show a significant association (HR, 1.43; 95% CI, 0.77–2.68). The increased mortality rate was observed for both pANCA and cANCA in patients suffering from rheumatic disorders. No association was found between mortality and anti-MPO (HR, 0.63; 95% CI, 0.20–2.00) or anti-PR3 (HR, 0.98; 95% CI, 0.24–3.96) after adjusting for confounders.ConclusionsSerum pANCA and cANCA are independent negative prognostic factors in patients with concurrent autoimmune diseases.

【 授权许可】

Unknown