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10.1146/annurev-pathol-011811-132453

http://scihub22266oqcxt.onion/10.1146/annurev-pathol-011811-132453
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suck abstract from ncbi


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pmid23347350      Annu+Rev+Pathol 2013 ; 8 (ä): 139-60
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  • Pathogenesis of Antineutrophil Cytoplasmic Autoantibody?Associated Small-Vessel Vasculitis #MMPMID23347350
  • Jennette JC; Falk RJ; Hu P; Xiao H
  • Annu Rev Pathol 2013[Jan]; 8 (ä): 139-60 PMID23347350show ga
  • Clinical, in vitro, and experimental animal observations indicate that antineutrophil cytoplasmic autoantibodies (ANCA) are pathogenic. The genesis of the ANCA autoimmune response is a multifactorial process that includes genetic predisposition, environmental adjuvant factors, an initiating antigen, and failure of T cell regulation. ANCA activate primed neutrophils (and monocytes) by binding to certain antigens expressed on the surface of neutrophils in specific inflammatory microenvironments. ANCA-activated neutrophils activate the alternative complement pathway, establishing an inflammatory amplification loop. The acute injury elicits an innate inflammatory response that recruits monocytes and T lymphocytes, which replace the neutrophils that have undergone karyorrhexis during acute inflammation. Extravascular granulomatous inflammation may be initiated by ANCA-induced activation of extravascular neutrophils, causing tissue necrosis and fibrin formation, which would elicit an influx of monocytes that transform into macrophages and multinucleated giant cells. Over time, the neutrophil-rich acute necrotizing lesions cause the accumulation of more lymphocytes, monocytes, and macrophages and produce typical granulomatous inflammation.
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