Relapse rate and renal prognosis in ANCA-associated vasculitis according to long-term ANCA patterns
CLINICAL AND EXPERIMENTAL IMMUNOLOGY
Authors: Oristrell, J.; Loureiro-Amigo, J.; Solans, R.; Valenzuela, M. P.; Monsalvez, V.; Segarra, A.; Amengual, M. J.; Marin, A.; Feijoo, C.; Tolosa, C.
Abstract
Long-term observation of patients with ANCA-associated vasculitis (AAV) allows the identification of different longitudinal patterns of ANCA levels during follow-up. This study aimed to characterize these patterns and to determine their prognostic significance. All ANCA determinations performed in two university hospitals during a 2-year period were retrospectively reviewed. Patients were included in the analysis if they had high titers of anti-myeloperoxidase (anti-MPO) or anti-proteinase 3 (anti-PR3) antibodies at least once, >= 5 serial ANCA determinations and AAV diagnosed by biopsy or American College of Rheumatology (ACR) classification criteria. Patients' time-course ANCA patterns were classified as monophasic, remitting, recurrent or persistent. Associations between ANCA patterns and prognostic variables (relapse rate and renal outcome) were analysed by univariate and multivariate statistics. A total of 99 patients [55 with microscopic polyangiitis (MPA), 36 with granulomatosis with polyangiitis (GPA) and eight with eosinophilic granulomatosis with polyangiitis (EGPA)] were included. Median follow-up was 9 years. Among patients diagnosed with MPA or GPA, recurrent or persistent ANCA patterns were associated with a higher risk of clinical relapse [hazard ratio (HR) = 3 center dot 7, 95% confidence interval (CI) = 1 center dot 5-9 center dot 1 and HR = 2 center dot 9, 95% CI = 1 center dot 1-8 center dot 0, respectively], independently of clinical diagnosis or ANCA specificity. In patients with anti-MPO antibodies, the recurrent ANCA pattern was associated with worsening renal function [odds ratio (OR) = 5 center dot 7, 95% CI = 1 center dot 2-26 center dot 0]. Recurrent or persistent ANCA patterns are associated with a higher risk of clinical relapse. A recurrent ANCA pattern was associated with worsening renal function in anti-MPO-associated vasculitis.
Fucoidan inhibits LPS-induced acute lung injury in mice through regulating GSK-3 beta-Nrf2 signaling pathway
ARCHIVES OF PHARMACAL RESEARCH
Authors: Zhu, De-Zhang; Wang, Yan-Ting; Zhuo, Yan-Li; Zhu, Kong-Juan; Wang, Xiang-Zhen; Liu, Ai-Jie
Abstract
The purpose of this study was to investigate the protective effects of fucoidan on Lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice. The mice were divided into the control, LPS, and LPS + fucoidan (20, 40, or 80 mg/kg) groups. LPS was given by intracheal instillation and fucoidan was given 1 h before LPS treatment. Myeloperoxidase (MPO) activity, malondialdehyde (MDA), superoxide dismutase (SOD), reactive oxygen species (ROS), glutathione (GSH) contents, and inflammatory cytokine production were detected. The results showed that LPS-induced TNF-alpha, IL-1 beta, and IL-6 production, lung wet/dry (W/D) ratio, ROS, MDA content, and MPO activity were suppressed by fucoidan. The levels of SOD and GSH were increased by fucoidan. Meanwhile, LPS-induced nuclear factor kappa-B (NF-kappa B) activation was dose-dependently attenuated by fucoidan. Furthermore, fucoidan increased the expression of nuclear factor erythroid-2 related factor 2 (Nrf2), Glycogen synthase kinase3 beta (GSK-3 beta), and heme oxygenase (HO-1). In vitro, the results demonstrated that fucoidan or GSK-3 beta inhibitor significantly inhibited LPS-induced TNF-alpha production in A549 cells. And the inhibition of fucoidan on TNF-alpha production was blocked by Nrf2 siRNA. This study showed fucoidan protected mice against LPS-induced ALI through inhibiting inflammatory and oxidative responses via regulating GSK-3 beta-Nrf2 signaling pathway.