{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:30:04Z","timestamp":1759941004840},"reference-count":77,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2004,7,23]],"date-time":"2004-07-23T00:00:00Z","timestamp":1090540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,7,23]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Pauci-immune idiopathic small-vessel vasculitis is strongly associated with the presence of antineutrophil cytoplasm autoantibodies (ANCA). Antibodies to PR3 predominate in patients with Wegener's granulomatosis; antibodies to myeloperoxidase (MPO) are found more frequently in patients with microscopic polyangiitis. There is increasing in vivo and in vitro evidence for a pathogenic role of ANCA in systemic vasculitis based on associations of ANCA with disease activity. If ANCA are pathogenic, why is the course of disease different from one patient to another? Antibodies can recognize different binding sites (epitopes) on their corresponding antigens. Differences in binding specificity may influence the pathogenic potential of the antibodies. Differences between epitope specificity of ANCA between patients or changes in epitope specificity of ANCA in time in an individual patient may, accordingly, result in differences in disease expression. This review will focus on epitope specificity of autoantibodies in systemic autoimmune diseases and especially on the epitope specificity of PR3\u2013 and MPO\u2013ANCA. We will discuss whether PR3\u2013ANCA or MPO\u2013ANCA recognize different epitopes on PR3 and MPO, respectively, and whether the epitopes recognized by ANCA change in parallel with the disease activity of ANCA-associated vasculitis. Finally, we will speculate if the direct pathogenic role of ANCA can be ascribed to one relapse- or disease-inducing epitope. Characterization of relapse- or disease-inducing epitopes bound by PR3\u2013ANCA and MPO\u2013ANCA is significant for understanding initiation and reactivation of ANCA-associated vasculitis. Elucidating a disease-inducing epitope bound by ANCA may lead to the development of epitope-specific therapeutic strategies.<\/jats:p>","DOI":"10.1111\/j.1365-2249.2004.02572.x","type":"journal-article","created":{"date-parts":[[2004,8,20]],"date-time":"2004-08-20T10:57:27Z","timestamp":1092999447000},"page":"451-459","source":"Crossref","is-referenced-by-count":20,"title":["B cell epitope specificity in ANCA-associated vasculitis: does it matter?"],"prefix":"10.1093","volume":"137","author":[{"given":"Y M","family":"VAN DER GELD","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C A","family":"STEGEMAN","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital Groningen, Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C G M","family":"KALLENBERG","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2004,8,9]]},"reference":[{"key":"2022011223191258500_b1","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1182\/blood.V89.10.3503","article-title":"Granules of the human neutrophilic polymorphonuclear leukocyte","volume":"89","author":"Borregaard","year":"1997","journal-title":"Blood"},{"key":"2022011223191258500_b2","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1002\/1529-0131(199809)41:9<1521::AID-ART2>3.0.CO;2-A","article-title":"Antineutrophil cytoplasmic antibodies","volume":"41","author":"Hoffman","year":"1998","journal-title":"Arthritis Rheum"},{"key":"2022011223191258500_b3","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1093\/ndt\/6.10.689","article-title":"Anti-neutrophil cytoplasmic antibodies and disease activity during long-term follow-up of 70 patients with systemic 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