The presence of staphylococcal superantigens in nasal swabs and correlation with activity of granulomatosis with polyangiitis (GPA) in own material.

Fijołek, Justyna; Wiatr, Elżbieta; Petroniec, Violetta; Augustynowicz–Kopeć, Ewa; Bednarek, Michał; Gawryluk, Dariusz; Martusewicz-Boros, Magdalena; Modrzewska, Katarzyna; Radzikowska, Elżbieta; Roszkowski‐Śliż, Kazimierz

doi:10.1183/13993003.congress-2018.pa3035

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…Recently, multiple sources of evidence have reinforced the concept of the central pathogenetic role of NETs in the pathogenesis of AAV as a source for the formation of ANCA [39]. There were several clinical studies evaluating a critical role of SAgs for GPA activity [15,40,41], but none, so far, investigated, whether there is a relation between SAgs presence and ANCA levels in patients with GPA. Our study seems to be the first analyzing this association.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study [15], we analyzed the relationship between the presence of SAgs in nasal swabs and GPA activity, but the aim of the current study was to determine the relationship between ANCA concentration and disease activity, while taking into account the association between ANCA formation and the presence of SAgs in nasal swabs in patients with GPA.…”

Section: Introductionmentioning

confidence: 99%

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Antineutrophil cytoplasmic antibodies and their relationship with disease activity and presence of staphylococcal superantigens in nasal swabs in patients having granulomatosis with polyangiitis: results of a study involving 115 patients from a single center

Fijołek¹,

Wiatr²,

Petroniec³

et al. 2019

Clin Rheumatol

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Objective Antineutrophil cytoplasmic antibodies (ANCAs) are considered a risk factor for granulomatosis with polyangiitis (GPA) exacerbation, especially when staphylococcal superantigens (SAgs) are present in nasal swabs. Their role in monitoring disease activity remains controversial. This study determined the relationship of ANCAs with disease activity and presence of SAgs in GPA patients. Methods Among a total of 115 GPA patients hospitalized in the period 2009-2016, we investigated the presence of SAgs and ANCA concentration. Blood samples and nasal swabs were taken at each visit (referred further to as episodes). Disease activity was assessed using the Birmingham Vasculitis Activity Score (BVAS). Results We analyzed 362 episodes. ANCAs were detected in 215 (59.4%), while SAgs were detected in 126 (34.8%) episodes. We found a significant correlation between the presence of ANCAs and disease activity (p = 0.0032), as well as between their level and GPA severity (r = 0.25363, p = 0.000001). We also determined that an ANCA values ≥ 138 Ru/ml were an indicator of active disease with high specificity and low sensitivity (84.4% and 37.3%, respectively). The relationship between ANCA presence and the presence of SAgs was not confirmed; however, when SAgs were analyzed based on the different types, ANCA levels were found to be significantly higher in the group with SAg type B (p = 0.031). Conclusions There was no detectable evidence for the association between ANCA level and the presence of SAgs. Although monitoring ANCA levels as a marker of disease activity may be clinically relevant, GPA management cannot proceed on the basis of ANCA levels alone. Key Points • ANCA concentration usually correlates with GPA activity, although in half of patients, ANCAs persist despite effective treatment and clinical remission. • ANCA values of 138 Ru/ml seem to be an indicator of active disease with high specificity, but low sensitivity. • Although there is a relevance for ANCA monitoring as a marker of disease activity, GPA management cannot be based on ANCA levels alone. • The suspected clinical correlation between ANCA formation and SAg presence in nasal swabs is not obvious and requires further investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antineutrophil cytoplasmic antibodies and their relationship with disease activity and presence of staphylococcal superantigens in nasal swabs in patients having granulomatosis with polyangiitis: results of a study involving 115 patients from a single center

Fijołek¹,

Wiatr²,

Petroniec³

et al. 2019

Clin Rheumatol

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“…Furthermore, it has been shown that a treatment with cotrimoxazole could prevent the occurrence of relapse [35]. The main influence of S. aureus on AAV activity is mainly attributed to its superantigens (SAgs), an extremely potent immunostimulatory molecules [36,37], but so far, the results of clinical studies evaluating a critical role of SAgs for AAV activity have not been unequivocal [38,39].…”

Section: The Mechanism Of Anca Formation In Aavmentioning

confidence: 99%

Antineutrophil cytoplasmic antibodies – their role in pathogenesis, diagnosis and treatment monitoring of ANCA-associated vasculitis

Fijołek¹,

Wiatr²

2020

cejoi

Self Cite

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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) constitutes a group of rare diseases characterized by necrotizing inflammation of small blood vessels and the presence of ANCA. Increasing clinical and experimental evidences support their pathogenic role in AAV, but the exact mechanism is not fully understood. Recently, the important role of neutrophil extracellular traps (NETs) in pathogenesis of AAV is underlined. There is an indication that NETs can be a source for the formation of ANCA. The most common ANCA target antigens are myeloperoxidase (MPO) and proteinase 3 (PR3). Though the mechanism of action of ANCA is still under exploration, ANCA serology is being increasingly used for classification of AAV and revealed as kenner in defining various disease subsets associated with different genetic background, clinical features, treatment response, and prognosis. Controversy exists regarding the utility of serial measurements of ANCA in patients with AAV to monitor treatment and predict disease relapse.

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“…Conversely, Fijolek and colleagues identified the presence of at least one SAg in 34.8% of GPA patients, but its presence was not associated with disease activity. However, earlier studies had not revealed a correlation between the presence of SAg genes and the expansion of specific T cell subsets in peripheral blood [116].…”

Section: Staphylococcus Aureus and Granulomatosis With Polyangiitismentioning

confidence: 99%

Staphylococcus aureus Nasal Carriage and Autoimmune Diseases: From Pathogenic Mechanisms to Disease Susceptibility and Phenotype

Ceccarelli

Perricone

Olivieri

et al. 2019

IJMS

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The role of infective agents in autoimmune diseases (ADs) development has been historically investigated, but in the last years has been strongly reconsidered due to the interest in the link between the microbiome and ADs. Together with the gut, the skin microbiome is characterized by the presence of several microorganisms, potentially influencing innate and adaptive immune response. S. aureus is one of the most important components of the skin microbiome that can colonize anterior nares without clinical manifestations. Data from the literature demonstrates a significantly higher prevalence of nasal colonization in ADs patients in comparison with healthy subjects, suggesting a possible role in terms of disease development and phenotypes. Thus, in the present narrative review we focused on the mechanisms by which S. aureus could influence the immune response and on its relationship with ADs, in particular granulomatosis with polyangiitis, rheumatoid arthritis, and systemic lupus erythematosus.

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The presence of staphylococcal superantigens in nasal swabs and correlation with activity of granulomatosis with polyangiitis (GPA) in own material.

Abstract: The work was created within the statutory activity of the National Research Institute of Tuberulosis and Lung Diseases in Warsaw, Poland, research task nr 1.10 "Molecular epidemiological investigation among staphylococci isolated from patients with granulomatosis with polyangiitis".

Cited by 6 publications

References 15 publications

Antineutrophil cytoplasmic antibodies and their relationship with disease activity and presence of staphylococcal superantigens in nasal swabs in patients having granulomatosis with polyangiitis: results of a study involving 115 patients from a single center

Antineutrophil cytoplasmic antibodies and their relationship with disease activity and presence of staphylococcal superantigens in nasal swabs in patients having granulomatosis with polyangiitis: results of a study involving 115 patients from a single center

Antineutrophil cytoplasmic antibodies – their role in pathogenesis, diagnosis and treatment monitoring of ANCA-associated vasculitis

Staphylococcus aureus Nasal Carriage and Autoimmune Diseases: From Pathogenic Mechanisms to Disease Susceptibility and Phenotype

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