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J Am Soc Nephrol. 2010 May;21(5):745-52. doi: 10.1681/ASN.2009121238. Epub 2010 Apr 15.

ANCA disease: where is this field heading?

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  • 1University of North Carolina Kidney Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599-7155, USA. ronald_falk@med.unc.edu

Abstract

ANCA disease remains a subject of great experimental and clinical interest. The subcategories of names and descriptions for this collection of vasculitides and necrotizing glomerulonephritides is still a subject of some debate. The various forms of ANCA disease share some characteristics, and similar therapies are often recommended for overlapping categories of disease. The immunopathogenic effects of myeloperoxidase and proteinase 3 antibodies are well established, and good mechanisms for initiation of disease are starting to emerge, particularly the role of autoantigen complementarity. Here we examine these various topics and discuss an approach to treatment.

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