Michel G, Ritter A, Gerken G, Meyer zum Büschenfelde K H, Decker R, Manns M P
Abbott Laboratories, European Research and Development, Wiesbaden, Germany.
Lancet. 1992 Feb 1;339(8788):267-9. doi: 10.1016/0140-6736(92)91332-3.
Anti-GOR is an autoantibody found in hepatitis C virus (HCV) infection. We have studied the specificity of this antibody for HCV infection in various groups of autoimmune liver diseases. Anti-HCV was detected by a second generation HCV enzyme-linked immunosorbent assay in 14 of 29 patients with liver-kidney-microsomal (LKM-1) -antibody-positive autoimmune hepatitis type 2 and in all 6 control patients with HCV-RNA-positive chronic hepatitis C. Anti-HCV was not found in those with antinuclear-antibody-positive autoimmune hepatitis type 1 (10 patients), with soluble-liver-protein-antibody-positive autoimmune hepatitis type 3 (8), with primary biliary cirrhosis (9), with systemic lupus erythematosus (SLE) (10), or in healthy controls (13). Anti-GOR was detected in 11 of 14 patients with autoimmune hepatitis type 2 who were all positive for anti-HCV but only in 1 of 15 LKM-1 patients who were negative for anti-HCV. We did not find anti-GOR in any other group of autoimmune liver disease, SLE, or control sera, but this antibody was detected in 3 of 6 patients with chronic hepatitis C. Autoimmune hepatitis type 2 patients who were anti-GOR positive and anti-HCV positive were less likely to be female, were older (p less than 0.001), and had lower LKM-1 antibody titres (p less than 0.001), lower disease activity, and responded less effectively to immuno- suppression than did those who were anti-HCV negative/anti-GOR negative. The findings show that anti-GOR reflects HCV-specific autoimmunity. HCV seems to induce autoimmunity to both GOR (an HCV-specific autoepitope) and LKM-1 (an epitope that is also recognised by autoimmune hepatitis sera of a different cause). Anti-GOR and LKM-1 antibodies contribute to a better differentiation of chronic hepatitis, a finding that has therapeutic implications.
抗GOR是在丙型肝炎病毒（HCV）感染中发现的一种自身抗体。我们研究了该抗体在各种自身免疫性肝病组中对HCV感染的特异性。采用第二代HCV酶联免疫吸附试验在29例肝肾微粒体（LKM-1）抗体阳性的2型自身免疫性肝炎患者中的14例以及所有6例HCV-RNA阳性的慢性丙型肝炎对照患者中检测到抗HCV。在10例抗核抗体阳性的1型自身免疫性肝炎患者、8例可溶性肝蛋白抗体阳性的3型自身免疫性肝炎患者、9例原发性胆汁性肝硬化患者、10例系统性红斑狼疮（SLE）患者或13例健康对照者中未发现抗HCV。在14例2型自身免疫性肝炎患者中的11例检测到抗GOR，这些患者抗HCV均为阳性，但在15例抗HCV阴性的LKM-1患者中仅1例检测到抗GOR。在任何其他自身免疫性肝病组、SLE组或对照血清中均未发现抗GOR，但在6例慢性丙型肝炎患者中的3例检测到该抗体。抗GOR阳性且抗HCV阳性的2型自身免疫性肝炎患者女性比例较低、年龄较大（p<0.001）、LKM-1抗体滴度较低（p<0.001）、疾病活动度较低，且免疫抑制治疗反应不如抗HCV阴性/抗GOR阴性的患者有效。研究结果表明，抗GOR反映了HCV特异性自身免疫。HCV似乎诱导对GOR（一种HCV特异性自身表位）和LKM-1（一种也被不同病因的自身免疫性肝炎血清识别的表位）的自身免疫。抗GOR和LKM-1抗体有助于更好地区分慢性肝炎，这一发现具有治疗意义。
