Ferucci Elizabeth D, Choromanski Tammy L, Hurlburt Kathy J, Livingston Stephen, Plotnik Julia, Manns Michael P, McMahon Brian J, James Judith A
Division of Community Health Services, Liver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
Liver Int. 2014 Sep;34(8):1241-9. doi: 10.1111/liv.12372. Epub 2013 Nov 25.
BACKGROUND & AIMS: The Alaska Native population is one of few populations in the world with a high prevalence of autoimmune hepatitis. The objective of this study was to determine the frequency and HLA and clinical associations of autoantibodies in Alaska Native people with autoimmune hepatitis.
Alaska Native individuals with autoimmune hepatitis were recruited in clinics conducted statewide. Sera were tested for the presence of autoantibodies described in either autoimmune hepatitis or rheumatic disease. Associations between autoantibodies and HLA alleles and clinical features were assessed.
Seventy-one patients were included. At the study visit, 34 patients (47.9%) had antibodies to double-stranded DNA by immunofluorescence; 27 (38.0%) had anti-neutrophil cytoplasmic antibodies; and 11 (15.5%) had anti-Ro antibodies. Only one person had antibodies against soluble liver antigen, and in that person, anti-Ro was absent. Associations were found between autoantibodies and HLA alleles, including positive associations between HLA DR3 and anti-double-stranded DNA antibodies and between HLA DR14 and antineutrophil cytoplasmic antibodies. There was no association between autoantibodies and clinical outcomes.
As in other populations, the prevalence of anti-double-stranded DNA antibodies and antineutrophil cytoplasmic antibodies is high in Alaska Native people with autoimmune hepatitis. In contrast to data from other populations, there is a lower prevalence of anti-soluble liver antigen and a lack of association between anti-Ro and anti-soluble liver antigen. In addition, the HLA profile and associations with autoantibodies are unique. No clear prognostic implications of autoantibodies have emerged in this population.
阿拉斯加原住民是世界上自身免疫性肝炎患病率较高的少数人群之一。本研究的目的是确定阿拉斯加原住民自身免疫性肝炎患者自身抗体的频率、人类白细胞抗原（HLA）及临床相关性。
在全州范围内的诊所招募患有自身免疫性肝炎的阿拉斯加原住民个体。检测血清中自身免疫性肝炎或风湿性疾病中描述的自身抗体的存在情况。评估自身抗体与HLA等位基因及临床特征之间的相关性。
共纳入71例患者。在研究访视时，34例患者（47.9%）免疫荧光法检测出抗双链DNA抗体；27例（38.0%）有抗中性粒细胞胞浆抗体；11例（15.5%）有抗Ro抗体。只有1人有抗可溶性肝抗原抗体，且该人无抗Ro抗体。发现自身抗体与HLA等位基因之间存在相关性，包括HLA DR3与抗双链DNA抗体之间以及HLA DR14与抗中性粒细胞胞浆抗体之间呈正相关。自身抗体与临床结局之间无相关性。
与其他人群一样，阿拉斯加原住民自身免疫性肝炎患者中抗双链DNA抗体和抗中性粒细胞胞浆抗体的患病率较高。与其他人群的数据相反，抗可溶性肝抗原的患病率较低，且抗Ro与抗可溶性肝抗原之间缺乏相关性。此外，HLA谱及与自身抗体的相关性是独特的。在该人群中，自身抗体没有明确的预后意义。
