Neutrophil cytoplasmic antigens

Antineutrophil cytoplasmic autoantibodies (ANCAs) have recently become an important diagnostic tool for vasculitis associated with Wegener's granuloma tosis and certain other microscopic vasculitis and glomerulonephritis disorders. The antibodies are detected primarily by IIF on isolated human neutrophils as substrate. Differences in fixation of the cells can separate the antibodies into two distinct groups with different specificities: C-ANCA and P-ANCA. Ethanol fixation causes a redistribution of the antigens of the P-ANCA specificity causing a 'perinuclear' (P) picture of the fluorescent staining, while C-ANCA remains cytoplasmic (C). Formaldehyde fixation prevents the redistribution of the P-ANCA antigens so that the binding of both antibodies appears cytoplasmic. The major antigen of the C-ANCA specificity has been reported as proteinase 3 of the a granules, while the major antigen of P-ANCA has been identified as myeloperoxidase. ELISA tests using specific antigens are currently being developed. The appearance and change in titer of these antibodies appear to be good indicators of remission/exacerbation and severity of disease.

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