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Giaglis, S; Daoudlarian, D; Thiel, J; Rizzi, M; Kyburz, D; Venhoff, N; Walker, UA.
Mitochondrial DNA: a novel indicator of active inflammation in ANCA-associated vasculitides.
Rheumatology (Oxford). 2023; 62(8):2930-2937 Doi: 10.1093/rheumatology/kead015 [OPEN ACCESS]
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Co-authors Med Uni Graz
Thiel Jens
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Abstract:
OBJECTIVES: ANCA-associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). ANCA triggers neutrophil extracellular trap formation, which releases either mitochondrial (mt) DNA or nuclear DNA (n) DNA, contributing to inflammation. Our aim was to prospectively examine the extent and nature of circulating DNA in AAV and the clinical utility of DNA quantification. METHODS: DNA was isolated from platelet-free plasma of consecutive GPA and MPA patients and healthy controls (HCs). mtDNA and nDNA copy numbers were quantified by PCR. Clinical data, including the BVAS, were collected. RESULTS: Ninety-two HCs (median age 51 years, 58.7% female) and 101 AAV patients (80 GPA, 21 MPA, median age 64 years, 50.5% female, BVAS range: 0-30) were included. Median mtDNA copies were 13-fold higher in patients with AAV than in HCs; nDNA concentrations did not differ. Patients with active AAV (BVAS > 0) had 4-fold higher median mtDNA copies than patients in remission (P = 0.03). mtDNA, unlike nDNA, correlated with BVAS (r = 0.30, P = 0.002) and was associated with AAV activity at multivariable analysis. Receiver operating characteristic curve analysis indicated that mtDNA quantification differentiates patients with active AAV (BVAS > 0) from HCs with 96.1% sensitivity and 98.9% specificity (area under the curve 0.99). In 27 AAV patients with follow-up, mtDNA changes but not CRP or ANCA-titres correlated with BVAS changes (r = 0.56, P = 0.002). CONCLUSIONS: mtDNA, unlike nDNA, is elevated in the plasma of AAV patients and may contribute to systemic inflammation. mtDNA could be superior to established biomarkers in the laboratory monitoring of AAV activity.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
Female - administration & dosage
Middle Aged - administration & dosage
Male - administration & dosage
Antibodies, Antineutrophil Cytoplasmic - administration & dosage
DNA, Mitochondrial - genetics
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - diagnosis, genetics
Microscopic Polyangiitis - administration & dosage
Inflammation - administration & dosage
Granulomatosis with Polyangiitis - administration & dosage

Find related publications in this database (Keywords)
ANCA-associated vasculitis
innate immunity
mitochondrial DNA
neutrophil extracellular traps
disease activity
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