{"id":69032,"date":"2025-04-23T11:16:28","date_gmt":"2025-04-23T15:16:28","guid":{"rendered":"https:\/\/www.med.unc.edu\/medicine\/?p=69032"},"modified":"2025-04-23T11:18:54","modified_gmt":"2025-04-23T15:18:54","slug":"unc-researchers-uncover-molecular-mechanism-behind-hydralazine-induced-anca-vasculitis","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/medicine\/news\/unc-researchers-uncover-molecular-mechanism-behind-hydralazine-induced-anca-vasculitis\/","title":{"rendered":"ºÚÁÏÍø Researchers Uncover Molecular Mechanism Behind Hydralazine-Induced ANCA Vasculitis"},"content":{"rendered":"

For the first time, investigators are gaining a clearer understanding of what causes drug-induced antineutrophil cytoplasmic autoantibody (ANCA) vasculitis.<\/p>\n

In a study<\/a> published in\u00a0The Journal of Clinical Investigation, researchers from the University of North Carolina (ºÚÁÏÍø) Department of Medicine and Kidney Center revealed that hydralazine\u2014a drug commonly used to treat high blood pressure\u2014alters the structure of myeloperoxidase (MPO), a key immune-related protein. These changes may trigger the autoimmune response seen in ANCA vasculitis.<\/p>\n

More specifically, the study found that the addition of a carbonyl group to MPO allows hydralazine to bind and form\u00a0hydrazone adducts. These structural changes in MPO appear to set off an immune reaction.<\/p>\n

\u201cNow we have an idea of what\u2019s happening at the molecular and cellular level that could actually trigger this autoimmune response and lead to disease,\u201d Meghan Free, PhD, an associate professor of medicine in the ºÚÁÏÍø Division of Nephrology and Hypertension said.<\/p>\n

\"\"<\/p>\n

Hydralazine has long been associated with drug-induced ANCA vasculitis, but the exact mechanism behind that link wasn\u2019t well understood, until now.<\/p>\n

A commentary<\/a>, published in the same issue, details how the study sheds light on the mechanisms by which hydralazine induces vasculitis. It serves as an example for understanding haptenation and drug-induced allergic or autoimmune diseases. Given the increasing number of allergic and autoimmune responses associated with drugs, the editorial also suggests the work of Gang Xi, PhD, an associate professor in the ºÚÁÏÍø Division of Nephrology and Hypertension, may provide a rational basis for tests which may predict whether a drug will lead to allergic and autoimmune responses prior to its prescription.<\/p>\n

Study Details<\/h3>\n

Five clinicians reviewed medical records to identify patients with hydralazine-associated vasculitis based on predetermined criteria. Ten patients with hydralazine-related disease were included in the study and compared with patients who had ANCA vasculitis but had\u00a0not\u00a0taken hydralazine.<\/p>\n

Notably, most of the patients on hydralazine tested positive for both proteinase 3 (PR3)- and MPO-ANCA antibodies.<\/p>\n

\u201cPatients with idiopathic vasculitis typically make antibodies to either MPO or PR3, not both,\u201d Dr. Free said. \u201cSo clinically, if a patient tests positive for both antibodies, it\u2019s a signal the disease could be drug-induced.\u201d<\/p>\n

Still, one big question remains:\u00a0Why do only some patients on hydralazine develop this autoimmune reaction, while others do not?<\/p>\n

Since drug-induced autoimmunity can act like a \u201cnatural experiment,\u201d uncovering its mechanisms may also shed light on how other autoimmune diseases, especially those with no known cause, develop.<\/p>\n

The study is titled, \u201c<\/em>Sequential carbonyl derivatives and hydrazone adduct formation on myeloperoxidase contribute to development of ANCA vasculitis<\/em><\/a>\u201d and was published by Gang Xi, Elizabeth McInnis, Olivier Lardinois, Peiqi Hu, John Poulton, Meghan Fre, Dhruti Chen, Evan Zeitler, Eveline Wu, Nicole Orzechowski, Vimal Derebail, J. Charles Jennette and Ronald Falk. <\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

For the first time, investigators are gaining a clearer understanding of what causes drug-induced antineutrophil cytoplasmic autoantibody (ANCA) vasculitis. In a study published in\u00a0The Journal of Clinical Investigation, researchers from the University of North Carolina (ºÚÁÏÍø) Department of Medicine and Kidney Center revealed that hydralazine\u2014a drug commonly used to treat high blood pressure\u2014alters the structure … Read more<\/a><\/p>\n","protected":false},"author":112673,"featured_media":69033,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"layout":"","cellInformation":"","apiCallInformation":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[101,2,583],"tags":[686],"class_list":["post-69032","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nephrology","category-news","category-research-news","tag-686","odd"],"acf":[],"yoast_head":"\nºÚÁÏÍø Researchers Uncover Molecular Mechanism Behind Hydralazine-Induced ANCA Vasculitis | Department of Medicine<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.med.unc.edu\/medicine\/news\/unc-researchers-uncover-molecular-mechanism-behind-hydralazine-induced-anca-vasculitis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ºÚÁÏÍø Researchers Uncover Molecular Mechanism Behind Hydralazine-Induced ANCA Vasculitis | Department of Medicine\" \/>\n<meta property=\"og:description\" content=\"For the first time, investigators are gaining a clearer understanding of what causes drug-induced antineutrophil cytoplasmic autoantibody (ANCA) vasculitis. In a study published in\u00a0The Journal of Clinical Investigation, researchers from the University of North Carolina (ºÚÁÏÍø) Department of Medicine and Kidney Center revealed that hydralazine\u2014a drug commonly used to treat high blood pressure\u2014alters the structure … Read more\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.med.unc.edu\/medicine\/news\/unc-researchers-uncover-molecular-mechanism-behind-hydralazine-induced-anca-vasculitis\/\" \/>\n<meta property=\"og:site_name\" content=\"Department of Medicine\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ºÚÁÏÍøDeptMedicine\" \/>\n<meta property=\"article:published_time\" content=\"2025-04-23T15:16:28+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-04-23T15:18:54+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2025\/04\/JCI178813.ga_.jpg\" \/>\n\t<meta property=\"og:image:width\" 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