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Autoantibodies Against Granulocyte Cytoplasm (cANCA/pANCA)

Granulocyte Mosaic 25

Granulocyte Mosaic 25 (granuloc. (EOH), granuloc. (HCHO), PR3, MPO, GBM, HEp-2+ granuloc. (EOH)): pANCA

  • Screening test for the detection of antibodies against granulocyte cytoplasm (ANCA).
  • Indications: Wegener‘s granulomatosis, various forms of glomerulonephritis, primary sclerosing cholangitis, ulcerative colitis, Crohn's disease.
  • Using ethanol-fixed granulocytes, antibodies against granulocyte cytoplasm can be detected. In this case, two fluorescence patterns have to be differentiated: a granular fluorescence which is distributed evenly over the entire cytoplasm, leaving the cell nuclei free (cytoplasmic type, cANCA) or a smooth fluorescence wrapped ribbon-like around the cell nuclei (perinuclear type, pANCA).
  • Antibodies against all relevant granulocyte antigens as well as against further, as yet unknown antigens are detected simultaneously (see table below).
  • The composite substrate HEp-2 cells + granulocytes allows differentiation between pANCA and anti-nuclear antibodies (ANA) which can easily be confused when using ethanol-fixed granu¬lo¬cytes. In the case of a positive ANA result all nuclei of the HEp-2 cells fluoresce, whereas in the case of pANCA (as well as cANCA) only the granulocytes fluoresce.
  • The substrates PR3 and MPO as monospecific tests can confirm results from conventional granulocyte screening tests. Recombinant GBM substrate also used for additional reliability for diagnosis. When fluorescence patters are unclear (e.g. unspecific fluorescence caused by other cytoplasmic antibodies) these substrates facilitate evaluation.
Pattern Target antigen Associated diseases
cANCA Proteinase 3 Wegener's granulomatosis
pANCA Myeloperoxidase Microscopic arteriitis, Churg-Strauss syndrome, polyarteriitis nodosa
pANCA Elastase Ulcerative colitis, Crohn's disease, primary sclerosing cholangitis, SLE
pANCA Cathepsin G Ulcerative colitis, primary sclerosing cholangitis, Crohn's disease
pANCA Lysozyme Ulcerative colitis, primary sclerosing cholangitis, Crohn's disease
pANCA Lactoferrin Ulcerative colitis, primary sclerosing cholangitis, Crohn's disease, SLE, rheumatoid arthritis
c/pANCA BPI Primary sclerosing cholangitis, ulcerative colitis, Crohn's disease
pANCA Unknown Colitis ulcerosa, Crohn's disease

Technical info and Images credit to EUROIMMUN AG