Honda Masao, Kawai Hiroshi, Shirota Yukihiro, Yamashita Taro, Takamura Toshinari, Kaneko Shuichi
Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, Takara-Machi 13-1, Kanazawa 920-8641, Japan.
J Autoimmun. 2005 Sep;25(2):133-40. doi: 10.1016/j.jaut.2005.03.009. Epub 2005 Sep 16.
While autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) usually have distinct clinical manifestations, some patients present with features of both conditions. Using cDNA microarrays, we analyzed and compared gene expression profiles in 8 patients with AIH, 9 with PBC, 8 with chronic hepatitis C (CHC), 8 with non-alcoholic steatohepatitis (NASH) and 9 with normal livers. We subsequently applied this method to a tissue sample from a 61-year-old woman with overlapping features of both AIH and PBC. A 61-year-old woman was admitted to our hospital for evaluation of elevated serum alkaline phosphatase. A liver biopsy showed accumulation of mononuclear cells around the bile duct cells, a feature characteristic of chronic non-suppurative destructive cholangitis (CNSDC). Three years later, her serum alanine aminotransferase (ALT) level had increased, and a liver biopsy demonstrated evidence of a severe form of hepatitis. A cDNA microarray analysis of both biopsies identified the molecular events associated with her altered histology. The expression profile of this patient, which was originally different from that of the other PBC patients, changed to an AIH pattern. Our results suggest that this patient has characteristics of both AIH and PBC.
自身免疫性肝炎（AIH）和原发性胆汁性肝硬化（PBC）通常具有不同的临床表现，但有些患者同时具有这两种疾病的特征。我们使用cDNA微阵列分析并比较了8例AIH患者、9例PBC患者、8例慢性丙型肝炎（CHC）患者、8例非酒精性脂肪性肝炎（NASH）患者以及9例正常肝脏患者的基因表达谱。随后，我们将该方法应用于一名具有AIH和PBC重叠特征的61岁女性的组织样本。一名61岁女性因血清碱性磷酸酶升高入院接受评估。肝脏活检显示胆管细胞周围有单核细胞积聚，这是慢性非化脓性破坏性胆管炎（CNSDC）的特征性表现。三年后，她的血清丙氨酸氨基转移酶（ALT）水平升高，肝脏活检显示为严重肝炎的证据。对两次活检进行的cDNA微阵列分析确定了与她组织学改变相关的分子事件。该患者最初与其他PBC患者不同的表达谱转变为AIH模式。我们的结果表明，该患者具有AIH和PBC的特征。
