New clue found to predict death because of ANCA-associated vasculitis

Korean medical researchers have found a new clue that predicts the death of patients with ANCA-associated vasculitis.

Professor Ha Jang-woo of the Department of Rheumatology at Yongin Severance Hospital, Dr. Yoon Tae-jun of Yonsei University College of Medicine, and Professor Lee Sang-won of the Department of Rheumatology at Severance Hospital said Wednesday that they could predict ANCA-associated vasculitis activity and death from the disease by analyzing the concentration of syndecan-1 in serum.

ANCA (anti-neutrophil cytoplasmic antibody)-associated vasculitis is an autoimmune disease that attacks capillaries and adjacent small arteries and veins throughout the body. It can invade significant organs, including the brain, heart, lungs, kidneys, intestines, and nerves, causing permanent damage, including stroke, cardiac arrest, respiratory failure, end-stage renal failure, and quadriplegia.

The researchers analyzed the serum syndecan-1 test results at the time of diagnosis in 79 patients diagnosed with ANCA-linked vasculitis at the Department of Rheumatology at Severance Hospital. They did so to see if it could predict disease activity at diagnosis and progression during follow-up.

The results showed that serum syndecan-1 was associated with ANCA-associated vasculitis activity and health status, including BVAS, FFS, SF-36, MCS, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Compared to controls, serum syndecan-1 concentrations above a certain cutoff value were associated with higher disease activity at diagnosis.

Those with serum syndecan-1 concentrations of 76.1 ng/mL or higher often had BVAS values in the highest tertile (top third), while those with concentrations of 60.0 ng/mL or higher often had BVAS values in the top 50 percent.

In addition, syndecan-1 concentrations above 120.1 ng/mL were associated with higher all-cause mortality during follow-up.

“This is the first study to investigate the role syndecan-1 in serum in patients with ANCA-associated vasculitis,” Professor Ha said. “We plan to conduct follow-up studies based on more clinical data, including test results after treatment or during relapse and recovery.”

The findings were recently published in the international journal Arthritis Research & Therapy.