原发性胆汁性肝硬化中国患者自身免疫性肝病相关自身抗体的流行情况。
Prevalence of autoimmune liver disease related autoantibodies in Chinese patients with primary biliary cirrhosis.
机构信息
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.41 Da Mu Cang, Western District, Beijing 100032, People's Republic of China.
出版信息
Dig Dis Sci. 2011 Nov;56(11):3357-63. doi: 10.1007/s10620-011-1756-1. Epub 2011 Jun 10.
BACKGROUND
The prevalence of autoimmune liver disease (AiLD)-related autoantibodies has not been defined in Chinese patients with primary biliary cirrhosis (PBC) and therefore needs to be characterized.
AIMS
The purpose of this study was to explore the prevalence of AiLD-related autoantibodies in Chinese patients with PBC.
METHODS
Indirect immunofluorescence was used to detect anti-mitochondrial antibodies (AMA) in the sera from 198 PBC, 44 autoimmune hepatitis (AIH) and 41 non-autoimmune liver disease controls (LDC). ELISA assays were used to test the presence of anti-M2, anti-gp210, anti-sp100, anti-SLA, anti-LC1 and anti-LKM-1 antibodies.
RESULTS
AMA was present in 92.4, 15.9 and 7.3%, respectively, of patients with PBC, AIH and LDC. Anti-M2 was present in 87.4% of the PBC patients, but only in 4.5 and 4.9%, respectively, of AIH and LDC patients. Anti-gp210 and anti-sp100 were detected in 34.3 and 25.8% of PBC, 6.8 and 15.9% of AIH and in 4.9 and 17.1% of LDC patients. Anti-LC1, anti-SLA and anti-LKM-1 were, respectively, present in 1.5, 0.0 and 0.5% of PBC, and 9.1, 11.4 and 2.3% of AIH, and none of LDC. PBC patients that were AMA-positive presented with higher IgM levels but lower CRP levels than negative ones. ALT, TBIL, DBIL, GGT, ALP, and AST were detected at higher levels and ALB at lower levels in PBC positive for anti-gp210 (P < 0.05).
CONCLUSIONS
The prevalence of AiLD-related autoantibodies we provided might help define PBC in China. Anti-sp100 is not a better prognostic marker for Chinese PBC patients compared to anti-gp210. The identification of effective diagnostic biomarkers for AMA-negative PBC patients is still needed.
背景
自身免疫性肝病（AiLD）相关自身抗体在原发性胆汁性胆管炎（PBC）中国患者中的流行情况尚未确定，因此需要进行特征描述。
目的
本研究旨在探讨 AiLD 相关自身抗体在中国人 PBC 患者中的流行情况。
方法
采用间接免疫荧光法检测 198 例 PBC、44 例自身免疫性肝炎（AIH）和 41 例非自身免疫性肝病对照组（LDC）患者血清中的抗线粒体抗体（AMA）。采用酶联免疫吸附试验（ELISA）检测抗 M2、抗 gp210、抗 sp100、抗 SLA、抗 LC1 和抗 LKM-1 抗体。
结果
PBC、AIH 和 LDC 患者的 AMA 阳性率分别为 92.4%、15.9%和 7.3%。抗 M2 存在于 87.4%的 PBC 患者中，而仅存在于 4.5%和 4.9%的 AIH 和 LDC 患者中。抗 gp210 和抗 sp100 存在于 34.3%和 25.8%的 PBC、6.8%和 15.9%的 AIH 以及 4.9%和 17.1%的 LDC 患者中。抗 LC1、抗 SLA 和抗 LKM-1 分别存在于 1.5%、0.0%和 0.5%的 PBC 患者和 9.1%、11.4%和 2.3%的 AIH 患者中，而 LDC 患者中均未发现。AMA 阳性的 PBC 患者的 IgM 水平较高，而 CRP 水平较低。与抗 gp210 阴性的 PBC 患者相比，抗 gp210 阳性的 PBC 患者的 ALT、TBIL、DBIL、GGT、ALP 和 AST 水平更高，ALB 水平更低（P < 0.05）。
结论
我们提供的 AiLD 相关自身抗体的流行情况可能有助于在中国确定 PBC。与抗 gp210 相比，抗 sp100 不是中国 PBC 患者更好的预后标志物。仍需要确定有效的 AMA 阴性 PBC 患者的诊断生物标志物。
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