Serum 20S proteasome levels are associated with disease activity in MPO-ANCA-associated microscopic polyangiitis
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BMC Rheumatology
RESEARCH ARTICLE
Open Access
Serum 20S proteasome levels are associated with disease activity in MPOANCA-associated microscopic polyangiitis Hiroshi Maruyama1, Kouichi Hirayama1* , Marina Yamashita1, Kentaro Ohgi1,2, Ryuji Tsujimoto1,3, Mamiko Takayasu1, Homare Shimohata1 and Masaki Kobayashi1
Abstract Background: Proteasomes are found in both the cell nucleus and cytoplasm and play a major role in the ubiquitindependent and -independent non-lysosomal pathways of intracellular protein degradation. Proteasomes are also involved in the turnover of various regulatory proteins, antigen processing, cell differentiation, and apoptosis. To determine the diagnostic value of serum proteasome in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), we investigated patients with AAV at various stages of the disease. Methods: Serum 20S-proteasome was measured by ELISA in 44 patients with MPO-ANCA-associated microscopic polyangiitis (MPA) and renal involvement. Thirty of the patients provided serum samples before the initial treatment, and 30 provided samples during remission; 16 provided samples at both time points. Results: The mean serum 20S-proteasome level was significantly higher in the active-vasculitis patients (3414.6 ± 2738.9 ng/mL; n = 30) compared to the inactive-vasculitis patients (366.4 ± 128.4 ng/mL; n = 30; p < 0.0001) and 40 controls (234.9 ± 90.1 ng/mL; p < 0.0001). There were significant positive correlations between the serum 20Sproteasome level and the Birmingham Vasculitis Activity Score (BVAS) (r = 0.581, p < 0.0001), the ANCA titer (r = 0.384, p < 0.0001), the white blood cell (WBC) count (r = 0.284, p = 0.0042), the platelet count (r = 0.369, p = 0.0002), and the serum C-reactive protein (CRP) level (r = 0.550, p < 0.0001). There were significant negative correlations between the serum 20S-proteasome level and both the hemoglobin concentration (r = − 0.351, p = 0.0003) and the serum albumin level (r = − 0.460, p < 0.0001). In a multiple regression analysis, there was a significant positive correlation between the serum 20S-proteasome level and only the BVAS results (β = 0.851, p = 0.0009). In a receiver operating curve analysis, the area under the curve for the serum 20S-proteasome level was 0.996, which is higher than those of the WBC count (0.738) and the serum CRP level (0.963). Conclusion: The serum level of 20S-proteasome may be a useful marker for disease activity in AAV. Keywords: ANCA-associated vasculitis, 20S-proteasome, Disease activity, Microscopic polyangiitis, Proteasome
* Correspondence: [email protected] 1 Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Ibaraki 300-0395, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit
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