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Immunol Res. 2019 Aug 1. doi: 10.1007/s12026-019-09091-x. [Epub ahead of print]

IgM ANCA in healthy individuals and in patients with ANCA-associated vasculitis.

Author information

1
Department of Nephrology, Royal Hobart Hospital, Liverpool Street, Hobart, Tasmania, 7000, Australia. lisa.jeffs@ths.tas.gov.au.
2
Department of Renal Medicine, Royal Adelaide Hospital, Adelaide, Australia.
3
Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, Australia.
4
Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia.
5
Department of Nephrology, Royal Hobart Hospital, Liverpool Street, Hobart, Tasmania, 7000, Australia.
6
Menzies Institute for Medical Research, Department of Statistics, University of Tasmania, Liverpool Street, Hobart, Tasmania, 7000, Australia.

Abstract

Low levels of IgM auto-antibodies have been reported in health and disease. IgM anti-neutrophil cytoplasmic antibodies (ANCA) have been reported in patients with ANCA-associated vasculitis (AAV). We sought to investigate if healthy individuals may have IgM ANCA in their sera. The first aim of the study was to determine whether IgM ANCA was present in healthy individuals and in patients with ANCA-associated vasculitis. The second aim was to determine what happens to IgM ANCA levels over time. The third aim was to determine whether bacterial infections affected IgM ANCA levels in non-AAV patients. Sera from healthy individuals and patients with AAV were tested for IgM ANCA by immunofluorescence on fixed neutrophils, immunoprecipitation, Western blot and ELISA. Peripheral blood mononuclear cells were isolated and tested by ELISpot for circulating IgM ANCA B cells. To determine whether infection affected IgM ANCA levels, we studied non-AAV patients with bacterial endocarditis or Staphylococcus aureus bacteraemia and measured IgM ANCA levels over time. IgM ANCA is detectable in both healthy individuals and patients with AAV and the titres decreased with increasing age. Circulating IgM ANCA B cells were identified by ELISpot. In the presence of infection, we could not find a significant change in IgM ANCA levels. We report the presence of low-level specific IgM ANCA in the sera of healthy individuals and in patients with ANCA-associated vasculitis. Bacterial infection did not affect the level of IgM ANCA in this small study.

KEYWORDS:

ANCA-associated vasculitis (AAV); Anti-neutrophil cytoplasmic antibodies (ANCA); IgM ANCA; Myeloperoxidase (MPO); Proteinase-3 (PR3)

PMID:
31372816
DOI:
10.1007/s12026-019-09091-x

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