The focus of my work has been on the characterization of anti-neutrophil cytoplasmic antibodies (ANCA), the development of tests for their detection, the correlation of the presence of the antibodies with different forms of vasculitis, and the value of such tests in clinical practice.

John L. Niles, MD 
Assistant Professor of Medicine 
149 13th Street
Charlestown, MA 02129
Phone: (617) 724-1897
Fax: (617) 742-3157
Email: jlniles@partners.org

 

We have shown that antibodies to proteinase 3 and myeloperoxidase are highly specific markers for the spectrum of vasculitis that includes Wegener's Granulomatosis, microscopic polyarteritis (polyangiitis), Churg-Strauss syndrome and pauci-immune necrotizing and crescentic glomerulonephritis with or without lung hemorrhage. By reviewing large numbers of patients and testing large control groups, we have determined the diagnostic value of these tests in a variety of clinical situations. Currently, we are working to further define the role of tests for ANCA and anti-glomerular basement membrane antibodies in the evaluation of pulmonary hemorrhage syndrome.

Another focus of our work is to define the value of serial tests for ANCA in the long term management of patients with the above spectrum of diseases. These patients require long term treatment with immunosuppression. Balancing the treatment between over immunosuppression and recurrence of disease has been a major clinical challenge. ANCA appear to be a highly useful tool in the management of these patients.

In addition to research regarding ANCA associated disease, I run a clinical practice that routinely sees patients with ANCA disease 3 days a week and provides coverage for these patients on a 24 hour per day, 7 day a week basis.

 

References:

  1. Vassilopoulos D, Niles JL, Villa-Forte A, Arroliga AC, Sullivan EJ, Merkel PA, and Hoffman GS. Prevalence of antineutrophil cytoplasmic antibodies in patients with various pulmonary diseases or multiorgan dysfunction. Arthritis Rheum. 2003 Apr 15. 49(2): 151-155.
  2. Han WK, Choi HK, Roth RM, McCluskey RT, and Nles JL. Serial ANCA titers: useful tool for prevention of relapses in ANCA-associated vasculitis. Kidney Int. 2003 Mar. 63(3): 1079-80.