Pathogenesis and biomarkers in ANCA-associated vasculitis

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of systemic autoimmune diseases associated with serum ANCA positivity that affect small to medium vessels with inflammation and endothelial injury. This group includes several diseases: granulomatosis with polyangiitis (GPA), microscopic polyangiitis, eosinophilic GPA, and drug-induced AAV. A few AAVs are ANCA negative, but this form has decreased with the increase in detection methods. Different genetic, epigenetic, and environmental risk factors contribute to the pathogenesis of AAV. ANCA’s role in the origin of vasculitis has led to a better grasp of the disease. Research has also improved the treatment, more precisely to tune its intensity, translating into better outcomes. However, there is still a gap to be filled with new potential and testable biomarkers for diagnosis, disease activity, and prognosis, which we discuss here