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Circulating Angiopoietin-2 as a Biomarker in ANCA-Associated Vasculitis
- Source :
- PLoS ONE, Vol 7, Iss 1, p e30197 (2012), PLoS ONE, 7(1):e30197. PUBLIC LIBRARY SCIENCE, PLoS ONE
- Publication Year :
- 2012
- Publisher :
- Public Library of Science (PLoS), 2012.
-
Abstract
- The endothelial-specific Angiopoietin-Tie2 ligand-receptor system is an important regulator of endothelial activation. Binding of angiopoietin-2 (Ang-2) to Tie2 receptor renders the endothelial barrier responsive to pro-inflammatory cytokines. We previously showed that circulating Ang-2 correlated with disease severity in a small cohort of critically ill patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis. The current study reassessed Ang-2 as a biomarker of disease activity and relapse in AAV. Circulating Ang-2 was measured in 162 patients with severe AAV (BVAS/WG >= 3, with or without glomerulonephritis) in a clinical trial. Ang-2 levels during active AAV were compared to levels in the same patients during remission (BVAS/WG = 0). Levels in clinical subsets of AAV were compared, and association with future disease course was assessed. Ang-2 levels were elevated in severe disease (median 3.0 ng/ml, interquartile range 1.9-4.4) compared to healthy controls (1.2, 0.9-1.5). However, they did not reliably decline with successful treatment (median 2.6 ng/ml, interquartile range 1.9-3.8, median change -0.1). Ang-2 correlated weakly with BVAS/WG score (r = 0.17), moderately with markers of systemic inflammation (r = 0.25-0.41), and inversely with renal function (r = -0.36). Levels were higher in patients with glomerulonephritis, but levels adjusted for renal dysfunction were no different in patients with or without glomerulonephritis. Levels were higher in patients with newly diagnosed AAV and lower in patients in whom treatment had recently been started. Ang-2 levels during active disease did not predict response to treatment, and Ang-2 levels in remission did not predict time to flare. Thus, Ang-2 appears to have limited practical value in AAV as a biomarker of disease activity at time of measurement or for predicting future activity.
- Subjects :
- Male
Anatomy and Physiology
lcsh:Medicine
ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES
Kidney
DISEASE-ACTIVITY
Systemic inflammation
Gastroenterology
0302 clinical medicine
Interquartile range
Immune Physiology
Molecular Cell Biology
Pathology
Medicine
lcsh:Science
0303 health sciences
Multidisciplinary
biology
Remission Induction
Glomerulonephritis
Middle Aged
Prognosis
C-REACTIVE PROTEIN
Disease Progression
Biomarker (medicine)
Female
Cellular Types
medicine.symptom
CRITICALLY-ILL PATIENTS
Glomerular Filtration Rate
Research Article
Systemic vasculitis
Adult
medicine.medical_specialty
Immunology
E-SELECTIN
Renal function
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
SYSTEMIC VASCULITIS
Autoimmune Diseases
Angiopoietin-2
03 medical and health sciences
WEGENERS-GRANULOMATOSIS
Rheumatology
SOLUBLE ADHESION MOLECULES
Diagnostic Medicine
Internal medicine
TIE-2 LIGAND ANGIOPOIETIN-2
Humans
Biology
Aged
030304 developmental biology
Anti-neutrophil cytoplasmic antibody
030203 arthritis & rheumatology
business.industry
lcsh:R
C-reactive protein
Immunity
medicine.disease
Multivariate Analysis
biology.protein
Clinical Immunology
lcsh:Q
FOLLOW-UP
business
Biomarkers
General Pathology
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 7
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....f38ca86d15fd5c292da6257f07ac7ae7