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自身免疫性肝病中的风湿性疾病自身抗体。

Rheumatic Disease Autoantibodies in Autoimmune Liver Diseases.

作者信息

Utiyama Shirley R R, Zenatti Katiane B, Nóbrega Heloisa A J, Soares Juliana Z C, Skare Thelma L, Matsubara Caroline, Muzzilo Dominique A, Nisihara Renato M

机构信息

a Immunopathology Laboratory , Clinics Hospital of Federal University of Paraná , Curitiba , Paraná , Brazil.

b Department of Clinical Analysis , Federal University of Paraná , Curitiba , Paraná , Brazil.

出版信息

Immunol Invest. 2016 Aug;45(6):566-73. doi: 10.1080/08820139.2016.1186173. Epub 2016 Jul 13.

Abstract

BACKGROUND

Autoimmune liver diseases (ALDs) are known to be associated with systemic autoimmune rheumatic diseases (SARDs) and their autoantibodies. We aimed to study the prevalence of SARDs and related autoantibodies, as well as their prognostic implications in a group of patients with ALDs.

METHODS

This was a cross-sectional study. Sixty patients with ALDs (38.3% with autoimmune hepatitis; 11.7% with primary biliary cirrhosis; 25% with primary sclerosing cholangitis and 25% with overlap syndrome) were studied for the presence of SARDs and their autoantibodies.

RESULTS

There was autoimmune rheumatic disease in 20% of the studied sample. Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) were the commonest (11.6% and 5%, respectively). Antinuclear antibodies (ANAs) were present in 35% of the patients, followed by anti-Ro (20.0%); anti-nucleosome (18.3%); rheumatoid factor (10%) anti-CCP (8.3%); anti-RNP (8.3%); anti-ds-DNA (6.6%); anti-La (3.3%); anti-Sm (3.3%), anti-ribosomal P (3.3%). Anti-Ro (p = 0.0004), anti-La (p = 0.03), anti-RNP (p = 0.04) and anti-Sm (p = 0.03) were commonly found in patients with SARD, but not anti-DNA, anti-nucleosome and anti-ribosomal P. No differences were found in liver function tests regarding to the presence of autoantibodies.

CONCLUSIONS

There was a high prevalence of SARD and their autoantibodies in ALD patients. Anti-Ro, anti-La, anti-RNP and anti-Sm positivity points to an association with systemic autoimmune rheumatic diseases. The presence of autoantibodies was not related to liver function tests.

摘要

背景

自身免疫性肝病(ALD)已知与系统性自身免疫性风湿病(SARD)及其自身抗体有关。我们旨在研究一组ALD患者中SARD及其相关自身抗体的患病率,以及它们对预后的影响。

方法

这是一项横断面研究。对60例ALD患者(自身免疫性肝炎患者占38.3%;原发性胆汁性肝硬化患者占11.7%;原发性硬化性胆管炎患者占25%;重叠综合征患者占25%)进行SARD及其自身抗体检测。

结果

在所研究的样本中,20%的患者患有自身免疫性风湿病。系统性红斑狼疮(SLE)和类风湿关节炎(RA)最为常见(分别为11.6%和5%)。35%的患者存在抗核抗体(ANA),其次是抗Ro(20.0%);抗核小体(18.3%);类风湿因子(10%)、抗环瓜氨酸肽(CCP)(8.3%);抗核糖核蛋白(RNP)(8.3%);抗双链DNA(ds-DNA)(6.6%);抗La(3.3%);抗Sm(3.3%),抗核糖体P(3.3%)。抗Ro(p = 0.0004)、抗La(p = 0.03)、抗RNP(p = 0.04)和抗Sm(p = 0.03)在SARD患者中常见,但抗DNA、抗核小体和抗核糖体P不常见。自身抗体的存在与肝功能检查结果无差异。

结论

ALD患者中SARD及其自身抗体的患病率较高。抗Ro、抗La、抗RNP和抗Sm阳性表明与系统性自身免疫性风湿病有关。自身抗体的存在与肝功能检查无关。

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