Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa
The aim of the study – to determine the diagnostic value of serum levels of endothelin-1, alpha-actin-2 and elastin in patients with primary systemic vasculitis. Materials and methods. Twenty eight patients with ANCA-associated vasculitis, 8 patients with polyarteritis nodosa of moderate or high...
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Zaporizhzhia State Medical and Pharmaceutical University
2020-02-01
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| Series: | Zaporožskij Medicinskij Žurnal |
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| Online Access: | http://zmj.zsmu.edu.ua/article/view/194478/195844 |
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| author | L. B. Petelytska O. B. Yaremenko |
| author_facet | L. B. Petelytska O. B. Yaremenko |
| author_sort | L. B. Petelytska |
| collection | DOAJ |
| description | The aim of the study – to determine the diagnostic value of serum levels of endothelin-1, alpha-actin-2 and elastin in patients with primary systemic vasculitis.
Materials and methods. Twenty eight patients with ANCA-associated vasculitis, 8 patients with polyarteritis nodosa of moderate or high vasculitis activity (BVAS >11) and 26 healthy subjects (control group) were examined. Serum levels of endothelin-1, alpha-actin-2 and elastin were determined by immunoassay using commercial kits of Biomedica, Biorbyt and Bender Medsystems.
Results. The level of endothelin-1 in patients with primary systemic vasculitis did not significantly differ from that of the control group, but its level (0.40 ± 0.33 pmol/l) was significantly higher in patients with kidney involvement (n = 15) compared with patients without kidney damage (0.28 ± 0.22 pmol/l, P = 0.04) and the control group (0.27 ± 0.10 pmol/l, P < 0.01). The level of alpha-actin-2 in the group of patients with ANCA-associated vasculitis was twice as high as in the control group (P < 0.05), which can be used for diagnosis this group of diseases (AUC 0.96 ± 0.16; 95 % CI 0.60–1.00; sensitivity 83 %, specificity 84 %, P <0.01). The level of elastin in the group of patients with polyarteritis nodosa was significantly higher not only in comparison to the control group (1.6 times, P < 0.05), but also in comparison to patients with ANCA-associated vasculitis (1.9 times, P < 0.01). According to the ROC analysis of the elastin diagnostic value for differential diagnosis of polyarteritis nodosa and ANCA-associated vasculitis, the AUC was 0.81 ± 0.10; 95 % CI 0.60–1.00; sensitivity 75 %, specificity 89 %, P < 0.01.
Conclusions. The elevated level of alpha-actin-2 with high sensitivity and specificity allows the diagnosis of ANCA-associated vasculitis in patients suspected of these diseases. The serum level of elastin is almost twice as high in patients with polyarteritis nodosa compared to patients with ANCA-associated vasculitis, which can be used in the differential diagnosis of primary systemic vasculitis. An elevated serum endothelin-1 level is found in patients with kidney damage. |
| format | Article |
| id | doaj-art-13028a2b9be746beafb3bb8155cc0526 |
| institution | Kabale University |
| issn | 2306-4145 2310-1210 |
| language | English |
| publishDate | 2020-02-01 |
| publisher | Zaporizhzhia State Medical and Pharmaceutical University |
| record_format | Article |
| series | Zaporožskij Medicinskij Žurnal |
| spelling | doaj-art-13028a2b9be746beafb3bb8155cc05262025-08-20T03:55:44ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102020-02-012212530https://doi.org/10.14739/2310-1210.2020.1.194478Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosaL. B. PetelytskaO. B. YaremenkoThe aim of the study – to determine the diagnostic value of serum levels of endothelin-1, alpha-actin-2 and elastin in patients with primary systemic vasculitis. Materials and methods. Twenty eight patients with ANCA-associated vasculitis, 8 patients with polyarteritis nodosa of moderate or high vasculitis activity (BVAS >11) and 26 healthy subjects (control group) were examined. Serum levels of endothelin-1, alpha-actin-2 and elastin were determined by immunoassay using commercial kits of Biomedica, Biorbyt and Bender Medsystems. Results. The level of endothelin-1 in patients with primary systemic vasculitis did not significantly differ from that of the control group, but its level (0.40 ± 0.33 pmol/l) was significantly higher in patients with kidney involvement (n = 15) compared with patients without kidney damage (0.28 ± 0.22 pmol/l, P = 0.04) and the control group (0.27 ± 0.10 pmol/l, P < 0.01). The level of alpha-actin-2 in the group of patients with ANCA-associated vasculitis was twice as high as in the control group (P < 0.05), which can be used for diagnosis this group of diseases (AUC 0.96 ± 0.16; 95 % CI 0.60–1.00; sensitivity 83 %, specificity 84 %, P <0.01). The level of elastin in the group of patients with polyarteritis nodosa was significantly higher not only in comparison to the control group (1.6 times, P < 0.05), but also in comparison to patients with ANCA-associated vasculitis (1.9 times, P < 0.01). According to the ROC analysis of the elastin diagnostic value for differential diagnosis of polyarteritis nodosa and ANCA-associated vasculitis, the AUC was 0.81 ± 0.10; 95 % CI 0.60–1.00; sensitivity 75 %, specificity 89 %, P < 0.01. Conclusions. The elevated level of alpha-actin-2 with high sensitivity and specificity allows the diagnosis of ANCA-associated vasculitis in patients suspected of these diseases. The serum level of elastin is almost twice as high in patients with polyarteritis nodosa compared to patients with ANCA-associated vasculitis, which can be used in the differential diagnosis of primary systemic vasculitis. An elevated serum endothelin-1 level is found in patients with kidney damage.http://zmj.zsmu.edu.ua/article/view/194478/195844systemic vasculitisanca-associated vasculitispolyarteritis nodosabiomarkersdiagnosisendothelin-1alpha-actin-2elastin |
| spellingShingle | L. B. Petelytska O. B. Yaremenko Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa Zaporožskij Medicinskij Žurnal systemic vasculitis anca-associated vasculitis polyarteritis nodosa biomarkers diagnosis endothelin-1 alpha-actin-2 elastin |
| title | Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa |
| title_full | Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa |
| title_fullStr | Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa |
| title_full_unstemmed | Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa |
| title_short | Clinical value of determining the markers of vascular wall damage in patients with ANCA-associated vasculitis and polyarteritis nodosa |
| title_sort | clinical value of determining the markers of vascular wall damage in patients with anca associated vasculitis and polyarteritis nodosa |
| topic | systemic vasculitis anca-associated vasculitis polyarteritis nodosa biomarkers diagnosis endothelin-1 alpha-actin-2 elastin |
| url | http://zmj.zsmu.edu.ua/article/view/194478/195844 |
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