Seasonal Influence on Development of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: A Retrospective Cohort Study Conducted at Multiple Institutions in Japan (J-CANVAS)

Yusuke Yoshida*, Naoki Nakamoto, Naoya Oka, Genki Kidoguchi, Yohei Hosokawa, Kei Araki, Michinori Ishitoku, Hirofumi Watanabe, Tomohiro Sugimoto, Sho Mokuda, Takashi Kida, Nobuyuki Yajima, Satoshi Omura, Daiki Nakagomi, Yoshiyuki Abe, Masatoshi Kadoya, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya KondoYasuhiko Yamano, Takuya Yanagida, Koji Endo, Kiyoshi Matsui, Tohru Takeuchi, Kunihiro Ichinose, Masaru Kato, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Takafumi Ito, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Toshiko Ito-Ihara, Takashi Kawaguchi, Yutaka Kawahito, Shintaro Hirata

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective. To clarify seasonal and other environmental effects on the onset of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV). Methods. We enrolled patients with new-onset eosinophilic granulomatosis with polyangiitis (EGPA), microscopic polyangiitis (MPA), and granulomatosis with polyangiitis (GPA) registered in the database of a Japanese multicenter cohort study. We investigated the relationship between environmental factors and clinical characteristics. Seasons were divided into 4 (spring, summer, autumn, and winter), and the seasonal differences in AAV onset were analyzed using Pearson chi-square test, with an expected probability of 25% for each season. Results. A total of 454 patients were enrolled, with a mean age of 70.9 years and a female proportion of 55.5%. Overall, 74, 291, and 89 patients were classified as having EGPA, MPA, and GPA, respectively. Positivity for myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA was observed in 355 and 46 patients, respectively. Overall, the seasonality of AAV onset significantly deviated from the expected 25% for each season (P = 0.001), and its onset was less frequently observed in autumn. In ANCA serotypes, seasonality was significant in patients with MPO-ANCA (P < 0.001), but not in those with PR3-ANCA (P = 0.97). Additionally, rural residency of patients with AAV was associated with PR3-ANCA positivity and biopsy-proven pulmonary vasculitis. Conclusion. The onset of AAV was influenced by seasonal variations and was less frequently observed in autumn. In contrast, the occurrence of PR3-ANCA was triggered, not by season, but by rural residency.

Original languageEnglish
Pages (from-to)1152-1158
Number of pages7
JournalJournal of Rheumatology
Volume50
Issue number9
DOIs
StatePublished - 2023/09/29

Keywords

  • antineutrophil cytoplasmic antibody
  • antineutrophil cytoplasmic antibody–associated vasculitis
  • eosinophilic granulomatosis with polyangiitis
  • granulomatosis with polyangiitis
  • microscopic polyangiitis
  • seasonal variation

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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