Fagoonee S, De Luca L, De Angelis C, Castelli A, Rizzetto M, Pellicano R
Molecular Biotechnology Center, University of Turin, Turin, Italy.
Minerva Gastroenterol Dietol. 2009 Mar;55(1):37-40.
Autoantibodies are disease markers of autoimmune hepatitis (AIH). Antinuclear antibodies, smooth muscle antibodies, antibodies to liver/kidney microsome type 1, and perinuclear antibodies to neutrophil cytoplasm constitute the ''conventional'' battery of autoantibodies, while an emerging interest to evaluate new autoantibodies as diagnostic or prognostic markers, such as the anti-Saccharomyces cerevisiae antibodies, is detectable (ASCA). This paper focuses mainly on the findings and the potential role of ASCA in AIH. These antibodies are present in 5-6.3% of blood donors and in the gastrointestinal setting, ASCA have been found most often in Crohn's disease and with lower frequency in the course of ulcerative colitis and celiac disease. Furthermore, they have been described, to a lesser extent, in patients with primary sclerosing cholangitis and primary biliary cirrhosis and in AIH. ASCA occur in 20-30% of patients suffering from AIH with a statistically significant increase observed only for IgG ASCA in type 1 AIH. This probably indicates collateral immune reactivities to the primary pathogenic process. The outcome of hepatitis is not influenced by the presence of ASCA. In conclusion, ASCA positivity does not imply that there exists a distinct subgroup of patients with AIH and these autoantibodies are not involved in the pathogenetic mechanism of AIH.
自身抗体是自身免疫性肝炎（AIH）的疾病标志物。抗核抗体、平滑肌抗体、抗肝肾微粒体1型抗体以及抗中性粒细胞胞质周缘抗体构成了“传统”的自身抗体组合，同时，人们开始关注评估新的自身抗体作为诊断或预后标志物，比如抗酿酒酵母抗体（ASCA）。本文主要聚焦于ASCA在AIH中的研究结果及潜在作用。这些抗体在5%-6.3%的献血者中存在，在胃肠道疾病中，ASCA最常见于克罗恩病，在溃疡性结肠炎和乳糜泻患者中出现频率较低。此外，在原发性硬化性胆管炎、原发性胆汁性肝硬化患者以及AIH患者中也有较少程度的报道。20%-30%的AIH患者存在ASCA，仅1型AIH中的IgG ASCA有统计学意义的显著增加。这可能表明对原发性致病过程存在附带的免疫反应性。肝炎的预后不受ASCA存在的影响。总之，ASCA阳性并不意味着存在一个独特的AIH患者亚组，并且这些自身抗体不参与AIH的发病机制。
