Monocyte Chemoattractant Protein 1 is a Prognostic Marker in ANCA-Associated Small Vessel Vasculitis

Abstract EN

Background.

The (anti neutrophil cytoplasmatic autoantibody ANCA), associated small vessel vasculitides (ASVV) are relapsing-remitting inflammatory disorders, involving various organs, such as the kidneys.

(Monocyte chemoattractant protein 1 MCP-1) has been shown to be locally up regulated in glomerulonephritis and recent studies have pointed out MCP-1 as a promising marker of renal inflammation.

Here we measure urinary cytokine levels in different phases of disease, exploring the possible prognostic value of MCP-1, together with (interleukin 6 IL-6), (interleukin 8 IL-8) and (immunoglobulin M IgM).

Methods.

MCP-1, IL-6 and IL-8 were measured using commercially available ELISA kits, whereas IgM in the urine was measured by an in-house ELISA.

Results.

The MCP-1 levels in urine were significantly higher in patients in stable phase of the disease, compared with healthy controls.

Patients in stable phase, with subsequent adverse events; had significantly higher MCP-1 values than patients who did not.

MCP-1 and IgM both tended to be higher in patients relapsing within three months, an observation, however, not reaching statistical significance.

Urinary levels of IL-6 correlated with relapse tendency, and IL-8 was associated with disease outcome.

Conclusions.

Patients with ASVV have raised cytokine levels in the urine compared to healthy controls, even during remission.

Raised MCP-1 levels are associated with poor prognosis and possibly also with relapse tendency.

The association with poor prognosis was stronger for U-MCP-1 than for conventional markers of disease like CRP, BVAS, and ANCA, as well as compared to candidate markers like U-IgM and U-IL-8.

We thus consider U-MCP-1 to have promising potential as a prognostic marker in ASVV.