In patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), serum superoxide dismutase (SOD) levels might be a surrogate marker for disease activity, according to findings from a single-center, retrospective study published in Advances in Rheumatology.

In individuals with AAV, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and Birmingham Vasculitis Score (BVAS) are commonly used to assess disease activity. Use of these biomarkers is considered less than satisfactory, however, with CRP levels and ESR easily affected by other factors, and BVAS difficult to use. Thus, the need exists to find other easy-to-use, effective biomarkers for evaluating disease prognosis and severity in patients with AAV.

The current study was conducted between January 2016 and October 2022 among patients with AAV who had been hospitalized at the Second Affiliated Hospital of Chongqing Medical University, located in Chongqing, China. The researchers obtained clinical and laboratory data on the following:

  • Patient demographics
  • Serum SOD levels
  • CRP levels
  • ESR
  • Detection of ANCA
  • Organ involvement
  • BVAS

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One hundred fifty-two patients with AAV were enrolled in the study. Overall, 74 of the participants with AAV were males and 78 were females. The average patient age in those with AAV was 64.07±14.81 years. A healthy control group comprised 150 individuals, 74 of whom were males and 76 of whom were females. The average age of these individuals was 63.56±13.67 years.

The most common organ/body system involvement in patients with AAV included pulmonary issues in 76.32% of participants and renal problems in 55.92%. Among those with AAV, 83.55% (127 of 152) of patients had myeloperoxidase (MPO)-ANCA and 16.45% (25 of 152) of individuals had protease3 (PR3)-ANCA. In addition, 15.13% (23 of 152) of the patients with AAV died.

Results of the study showed that the SOD level in the healthy control group was 131.03±14.23 U/mL compared with a statistically significant lower level of 78.97±31.36 U/mL in the patients with AAV (P <.001).

When relationships between SOD levels and disease activity were analyzed in patients with AAV, SOD concentrations in those with AAV were negatively correlated with CRP, ESR, and BVAS (P <.001 for all).

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All participants with AAV were divided into 2 groups according to ANCA serology. In the MPO-ANCA group, SOD levels were 72.70 U/mL compared with 89.40 U/mL in the PR3-ANCA group (P =.045).

Further, SOD levels in the pulmonary involvement arm and the renal involvement arm were statistically significantly lower than levels in the nonpulmonary involvement group and the nonrenal involvement group (P =.006 and
P <.001, respectively). Also, SOD concentrations in the group that died were significantly lower than those in the survival group (P =.001).

“In patients with AAV, low SOD levels might indicate disease associated oxidative stress,” the authors noted. “SOD levels in patients with AAV were decreased with inflammation . . . low SOD levels are an important indicator of a poor prognosis for patients with AAV,” the authors concluded.


Zhang Z, Huan W, Ren F, Luo L, Zhou J, Tang L. Measurement of superoxide dismutase: clinical usefulness for patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. Adv Rheumatol. Published online June 28, 2023. doi:10.1186/s42358-023-00312-4