IGG SUBCLASSES OF ANTINEUTROPHIL CYTOPLASM AUTOANTIBODIES (ANCA)

Sera that had been positive in routine ELISA for ANCA were studied ret rospectively for the IgG subclass distribution of these autoantibodies . An ELISA previously developed for measurement of IgG subclasses of a nti-GBM antibodies was modified for this purpose. Of a total of 247 se ra, 114 were found to be positive in at least one of the assays for Ig G subclasses of anti proteinase 3, 72 of these patients were men and 4 2 were women, giving a ratio of 1.8. Also 134 sera were positive in at least one of the IgG subclass assays for antimyeloperoxidase (MPO), w ith a male/female ratio of 0.97. The ANCA seem to consist mainly of Ig G1 and IgG4 autoantibodies. Among the anti-MPO group, IgG2 is relative ly common and IgG3 is scarce. Contrasting with this, IgG3 is relativel y common in the antiproteinase 3 group. In this group high IgG2 titres are rare. Twelve sera were found to be positive for both autoantigens . Clinical data were studied for 44 patients. Prognosis for old patien ts was found to be poor. Patients with inactive disease were often pos itive in only one subclass assay, while patients with active disease w ere positive in two or more subclass assays (P<0.01).