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Antineutrophil cytoplasm autoantibodies in patients with tuberculosis are directed against bactericidal/permeability increasing protein and are detected after treatment initiation

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2010 Vol.28, N°1 ,Suppl.57
PI 0035, PF 0039
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PMID: 20412700 [PubMed]

Received: 18/09/2009
Accepted : 13/01/2010
In Press: 22/04/2010
Published: 22/04/2010


To determine the prevalence of antineutrophil cytoplasm autoantibodies (ANCA) and its antigenic specificities in sera of patients with pulmonary tuberculosis (Tb) before and after treatment. PATIENTS AND
Sixty-eight patients with culture-proven Tb were studied for the presence of ANCA, both by indirect immunofluorescence (IIF) and ELISA against proteinase-3 (PR3), myeloperoxidase (MPO) and bactericidal/permeability increasing protein (BPI). They were sought before treatment and in 52 of them also after therapy for the infection. High sensitivity C-reactive protein (CRP) was also measured at both times.
ANCA by IIF were found in 3/68 (4.4%) sera prior to treatment, one C-ANCA and two P-ANCA, all recognizing BPI. After treatment, this increased to 15/52 (28.8%), 3 C-ANCA and 12 P-ANCA, the majority directed against BPI (11/15, 73%). BPI-ANCA were positive in 6/68 (8.8%) and 15/52 (28.8%) before and after Tb after treatment initiation (p=0.003). PR3-ANCA and MPO-ANCA were negative in all Tb sera. A positive ANCA test correlated with CRP as inflammatory marker (p=0.001).
The prevalence of ANCA in culture positive Tb patients is modified by Tb chemotherapy. BPI is the main target antigen for ANCA in tuberculosis and BPI-ANCA increase after treatment.

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