Experimental autoimmune vasculitis: an animal model of anti-neutrophil cytoplasmic autoantibody-associated systemic vasculitis

The morbidity burden associated with anti-neutrophil cytoplasmic autoantibody-associated vasculitis is increasing, and many novel biological therapies are now entering the drug development pipeline. There is thus an urgent need to develop a representative animal model to facilitate testing of these agents. We previously examined the effect of antineutrophil cytoplasmic autoantibody on leukocyte-endothelial interactions in WKY rats via immunization with human myeloperoxidase. We now seek to extend this model so that all animals reliably develop crescentic glomerulonephritis and lung hemorrhage. We also wish to investigate whether there is a genetic contribution to vasculitis development in this rat strain. Using escalating doses of human myeloperoxidase, we found that a dose of 1600 microg/kg induced pauci-immune crescentic glomerulonephritis and lung hemorrhage in all immunized animals. We also found that the addition of pertussis toxin and killed Mycobacterium tuberculosis to the adjuvant when immunizing with 400 microg/kg of myeloperoxidase resulted in crescentic glomerulonephritis and lung hemorrhage in all animals. However, when Lewis, Wistar Furth, or Brown Norway rats were immunized using a similar protocol, no animals developed hematuria or glomerulonephritis, despite having identical levels of anti-human myeloperoxidase antibodies. We conclude that, by adjusting the immunization regimen, all WKY rats immunized with myeloperoxidase develop experimental autoimmune vasculitis, thus facilitating future therapeutic studies. The resistance of Lewis rats to experimental autoimmune vasculitis provides a genetic basis for future studies of anti-myeloperoxidase antibody-associated vasculitis.

The class II phosphoinositide 3-kinase PI3K-C2beta regulates cell migration by a PtdIns3P dependent mechanism

The biological and pathophysiological significance of class II phosphoinositide 3-kinase enzyme expression currently remains unclear. Using an in vitro scrape wound assay and time-lapse video microscopy, we demonstrate that cell motility is increased in cultures expressing recombinant PI3K-C2beta enzyme. In addition, overexpression of PI3K-C2beta transiently decreased cell adhesion, stimulated the formation of cytoplasmic processes, and decreased the rate of cell proliferation. Consistent with these observations, expression of PI3K-C2beta also decreased expression of alpha4 beta1 integrin subunits. Using asynchronous cultures, we show that endogenous PI3K-C2beta is present in lamellipodia of motile cells. When cells expressing recombinant PI3K-C2beta were plated onto fibronectin, cortical actin staining increased markedly and actin rich lamellipodia and filopodia became evident. Overexpression of a 2xFYVE(Hrs) domain fusion protein abolished this response demonstrating that the effect of PI3K-C2beta on the reorganization of actin filaments is dependent upon PtdIns3P. Finally, overexpression of PI3K-C2beta increased GTP loading of Cdc42. Our data demonstrates for the first time, that PI3K-C2beta plays a regulatory role in cell motility and that the mechanism by which it reorganizes the actin cytoskeleton is dependent upon PtdIns3P production.

Development of the BD-QoL: a quality of life measure specific to Behçet's disease

OBJECTIVE

Current outcome measures for patients with Behçet's disease (BD) are impairment-focused and do not necessarily take account of the wider impact of the condition on the individual's lifestyle. Our aim was to develop a disease-specific measure of quality of life (QoL) for BD.

METHODS

The content of the BD-QoL was derived from qualitative interviews with patients using a "needs-based" approach to identify items. A postal survey was used to test the scaling properties, reliability, internal consistency, and validity of the new questionnaire using Rasch analysis. A second postal survey was used to assess test-retest reliability and internal consistency and to provide further evidence of the validity of the questionnaire.

RESULTS

Main themes emerging from the qualitative interviews included relationships, emotions, limitations in day to day activities, and self-image. From these themes 71 statements were chosen as potential items for the BD-QoL. After analysis, 30 items of the BD-QoL emerged free of item bias for age and sex. Fit to the Rasch model was excellent. In the second postal survey test-retest reliability of the 30 item BD-QoL was 0.84.

CONCLUSION

The BD-QoL provides the clinician with a simple, reliable, and valid tool for assessing the influence of interventions for BD and for evaluating models of service delivery. It is well accepted by patients, and has excellent scaling and psychometric properties. The BD-QoL complements information obtained through BD-specific disease activity scales.