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Objective: To detect the concentration of circulating antibodies targeting C3a and C5a complement receptors in ANCA-associated vasculitis (AAV) and to analyze their correlation
with disease activity.
Methods: The concentrations
of C3a and C5a complement receptor antibodies and plasma complement fragments C3a and C5a in patients with AAV (n=110; granulomatosis with polyangiitis [GPA, n=82], microscopic polyangiitis [MPA, n=28]), systemic lupus erythematosus (SLE, n=36) and healthy donors (HD, n=220) were measured.
C3aR and C5aR expression
of circulating neutrophils, monocytes, and T cells were analyzed using flow cytometry.
Clinical data
were assessed at the time of serological sampling and during 60-month follow-up.
Results: In AAV, anti-C3aR and anti-C5aR antibodies decreased (P = 0.
0026 and P≤0.
0001).
During remission, anti-C3aR antibody concentrations rise to values comparable to HD, while anti-C5aR concentrations do not
.
In GPA, C5a and anti-C5aR antibody concentrations were negatively correlated with each other (r=-0.
6831, P=0.
0127).
In newly diagnosed GPA, a decrease in concentration of anti-C5aR antibody, rather than anti-C3aR antibody, was associated with disease activity (P = 0.
0009).
。
In addition, low anti-C5aR antibodies were associated with GPA (HR: 3.
54, P = 0.
0009) and MPA (HR: 4.
41, P = 0.
0041) recurrence.
The frequency of C5aR-expressing cells in the T cell population of the GPA group increased (CD4+ T cells: P = 0.
0021; CD8+ T cells: P = 0.
0118), but not
in the MPA group.
Conclusion: Low concentrations of anti-C5aR antibodies reflect disease activity and are associated with an increased risk of AAV recurrence.
Sources:
Klapa S, Müller A, Koch A, et al.
Low concentrations of C5a complement receptor antibodies are linked to disease activity and relapse in ANCA-associated vasculitis [published online ahead of print, 2022 Nov 21].
Arthritis Rheumatol.
2022; 10.
1002/art.
42410.
doi:10.
1002/art.
42410
