Anti-neutrophil cytoplasmic antibodies (ANCA) in the clinical forms of leprosy

Anti-neutrophil cytoplasmic antibodies (ANCA) are autoantibodies against en zymes present in primary granules of neutrophils and lysosomes of monocytes detected in systemic vasculitis and in other diseases, including infection s, ANCA are markers of active Wegener granulomatosis, which presents some a natomo-pathologic and immune response features similar to those of leprosy. Thus, we raised the hypothesis that ANCA may be present in leprosy as mark ers specifically linked to the presence of vasculitis. The aim of this stud y was to determine the presence of ANCA in leprosy and its correlation with the clinical forms of the disease. Sera from 60 normal individuals and fro m 59 patients with different clinical forms of leprosy were studied. The pa tients were also allocated into reactional and nonreactional groups. By ind irect immunofluorescence, ANCA were positive, an atypical pattern A-ANCA, i n 28.8% of the patient sera. A-ANCA predominated, although not significantl y (p >0,05), in the reactional groups (37.9% vs 20.0%), and in those at the lepromatous pole (41.6% vs 20.0%). There was no correlation between ANCA p ositivity and either disease duration, disease activity, or therapeutic reg imen (p >0.05), An interesting finding was the correlation between ANCA and gender: 94.1% of ANCA-positive patients were males (p <0.01), a feature th at so far has not been reported in ANCA-related diseases and for which ther e is no explanation at the moment. By ELISA, the sera of the lepromatous le prosy patients did not show activity against either PR3, MPO, HLE, the most common ANCA antigens. Because A-ANCA are nonspecific, this finding require s further investigation for the determination of the responsible antigen(s) , in conclusion, A-ANCA are present in 28.8% of leprosy patients but are no t related to vasculitis in the erythema nodosum leprosum reaction and are n ot a marker of a specific clinical form.