PANCA ANTIBODIES IN PATIENTS WITH ANTERIOR UVEITIS - IDENTIFICATION OF A MARKER ANTIBODY USUALLY ASSOCIATED WITH ULCERATIVE-COLITIS

A pANCA autoantibody (antineutrophil cytoplasmic antibody, perinuclear pattern) has been described in uveitis patients, but its correlation with systemic illnesses and the specific type of pANCA has not been de fined. The goals of this study were to determine the (1) frequency of pANCA autoantibodies in uveitis, (2) systemic associations in the pANC A+ uveitis patients, and (3) type of pANCA antigen recognized by the u veitis-associated autoantibody. Serum was obtained from 59 patients wi th anterior uveitis or panuveitis and from nonuveitis controls. A deta iled medical and family history was obtained from each subject at the time of phlebotomy. Sera were screened by neutrophil ELISA to determin e the frequency of ANCA positivity. Immunofluorescence assays were the n used to differentiate cANCA from pANCA. The specificity of the pANCA + antibodies was further characterized by DNase 1 sensitivity and gran ule antigen ELISAs. ANCA antibodies were detected in 29% of all patien ts with panuveitis or anterior uveitis. In 41% of these ANCA+ patients , serum antibody detected a perinuclear antigen that was sensitive in all cases to DNase 1. The majority of pANCA+ uveitis patients were eit her HLA-B27 positive or had systemic evidence of immune-mediated disea ses. Two pANCA+ patients had no medical or family history of other imm une-mediated diseases. This study identifies a subset of uveitis patie nts distinguished by expression of a specific pANCA marker antibody. T he characteristics of this antibody are similar to the pANCA antibody present in most patients with ulcerative colitis. Expression of the pA NCA autoantibody in uveitis patients is a susceptibility marker for ot her immune-mediated diseases.