P-ANCA

p-ANCA, or MPO-ANCA, or Perinuclear Anti-Neutrophil Cytoplasmic Antibodies, show a perinuclear staining pattern.

This pattern occurs because the vast majority of the antigens targeted by ANCAs are highly cationic (Positively charged) at pH 7.00. During ethanol (pH ~7.0 in water) fixation, antigens which are more cationic migrate and localize around the nucleus, attracted by its negatively charged DNA content. Antibody staining therefore results in fluorescence of the region around the nucleus.

By far the most common p-ANCA target is myeloperoxidase (MPO), a neutrophil granule protein whose primary role in normal metabolic processes is generation of oxygen radicals.

ANCA will less commonly form against alternative antigens that may also result in a p-ANCA pattern. These include lactoferrin; elastase; and cathepsin G.

When the condition is a vasculitis, the target is usually MPO. However, the proportion of p-ANCA sera with anti-MPO antibodies has been reported to be as low as 12%.

p-ANCA is associated with several medical conditions:

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