検査と技術52巻1号

2024年01月発行

技術講座 その他

抗好中球細胞質抗体検査

著者： 川嶋聡子¹

所属機関： ¹杏林大学医学部腎臓・リウマチ膠原病内科

ページ範囲：P.32 - P.36

Point

●抗好中球細胞質抗体（ANCA）は，ANCA関連血管炎における診断，および疾患活動性を反映する有用な自己抗体である．

●ANCA測定の優先順位は，EIA法を第一選択とし，ANCA陰性例や低力価の場合にEIA法での再検査を行い，IIF法で確認する．

●ANCA陰性や偽陽性，疾患活動性と一致しない症例，持続陽性症例も一定の割合で存在するため，臨床症状やその他の検査所見などから総合的に判断する必要がある．

参考文献

1）Jennette JC, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013; 65: 1-11.

2）Sada KE, et al. Comparison of severity classification in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study. Mod Rheumatol. 2016; 26: 730-737.

3）Csernok E, Moosig F. Current and emerging techniques for ANCA detection in vasculitis. Nat Rev Rheumatol. 2014; 10: 494-501.

4）Hagen EC, et al. Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization. Kidney Int. 1998; 53: 743-753.

5）FijoŁek J, Wiatr E. Antineutrophil cytoplasmic antibodies (ANCA) - their role in pathogenesis, diagnosis, and treatment monitoring of ANCA-associated vasculitis. Cent Eur J Immunol. 2020; 45: 218-227.

6）Damoiseaux J, et al. Detection of antineutrophil cytoplasmic antibodies (ANCAs): a multicentre European Vasculitis Study Group (EUVAS) evaluation of the value of indirect immunofluorescence (IIF) versus antigen-specific immunoassays. Ann Rheum Dis. 2017; 76: 647-653.

7）Rasmussen N, et al. An ELISA for the detection of anti-neutrophil cytoplasm antibodies (ANCA). J Immunol Methods. 1990; 127: 139-145.

8）Hirose O, et al. Comparison of a novel chemiluminescence enzyme immunoassay (CLEIA) with enzyme-linked immunosorbent assay (ELISA) for the determination of MPO-ANCA in patients with ANCA-associated vasculitis. Mod Rheumatol. 2015; 25: 230-234.

9）Csernok E, et al. Anti-neutrophil cytoplasm antibodies (ANCA): Recent methodological advances-Lead to new consensus recommendations for ANCA detection. J Immunol Methods. 2018; 456: 1-6.

10）Thai LH, et al. Are anti-proteinase-3 ANCA a useful marker of granulomatosis with polyangiitis (Wegener's) relapses? Results of a retrospective study on 126 patients. Autoimmun Rev. 2014; 13: 313-318.

11）Terrier B, et al. Antimyeloperoxidase antibodies are a useful marker of disease activity in antineutrophil cytoplasmic antibody-associated vasculitides. Ann Rheum Dis. 2009; 68: 1564-1571.

12）Tomasson G, et al. Value of ANCA measurements during remission to predict a relapse of ANCA-associated vasculitis--a meta-analysis. Rheumatology (Oxford) 2012; 51: 100-109.

13）Yamaguchi M, et al. Increase of Antimyeloperoxidase Antineutrophil Cytoplasmic Antibody (ANCA) in Patients with Renal ANCA-associated Vasculitis: Association with Risk to Relapse. J Rheumatol. 2015; 42: 1853-1860.

14）Kawashima S, et al. MPO-ANCA-positive Microscopic Polyangiitis Following COVID-19 Infection. Intern Med. 2022; 61: 567-570.

15）Moiseev S, et al. 2020 international consensus on ANCA testing beyond systemic vasculitis. Autoimmun Rev. 2020; 19: 102618.