Amin Kawa, Rasool Aram H, Hattem Ali, Al-Karboly Taha Am, Taher Taher E, Bystrom Jonas
Kawa Amin, Department of Medical Science, Respiratory Medicine and Allergology, Clinical Chemistry and Asthma Research Centre, Uppsala University and University Hospital, SE-751 85 Uppsala, Sweden.
World J Gastroenterol. 2017 Feb 28;23(8):1345-1352. doi: 10.3748/wjg.v23.i8.1345.
To determine how the auto-antibodies (Abs) profiles overlap in chronic hepatitis C infection (CHC) and autoimmune hepatitis (AIH) and correlate to liver disease.
Levels of antinuclear Ab, smooth muscle antibody (SMA) and liver/kidney microsomal-1 (LKM-1) Ab and markers of liver damage were determined in the sera of 50 patients with CHC infection, 20 AIH patients and 20 healthy controls using enzyme linked immunosorbent assay and other immune assays.
We found that AIH patients had more severe liver disease as determined by elevation of total IgG, alkaline phosphatase, total serum bilirubin and serum transaminases and significantly higher prevalence of the three non-organ-specific autoantibodies (auto-Abs) than CHC patients. Antinuclear Ab, SMA and LKM-1 Ab were also present in 36% of CHC patients and related to disease severity. CHC cases positive for auto-Abs were directly comparable to AIH in respect of most markers of liver damage and total IgG. These cases had longer disease duration compared with auto-Ab negative cases, but there was no difference in gender, age or viral load. KLM-1 Ab CHC cases showed best overlap with AIH.
Auto-Ab levels in CHC may be important markers of disease severity and positive cases have a disease similar to AIH. Auto-Abs might have a pathogenic role as indicated by elevated markers of liver damage. Future studies will unravel any novel associations between these two diseases, whether genetic or other.
确定慢性丙型肝炎感染（CHC）和自身免疫性肝炎（AIH）中自身抗体（Abs）谱如何重叠并与肝病相关。
使用酶联免疫吸附测定法和其他免疫测定法，测定50例CHC感染患者、20例AIH患者和20例健康对照者血清中的抗核抗体、平滑肌抗体（SMA）和肝肾微粒体-1（LKM-1）抗体水平以及肝损伤标志物。
我们发现，通过总IgG、碱性磷酸酶、总血清胆红素和血清转氨酶升高来确定，AIH患者的肝病更严重，并且三种非器官特异性自身抗体（自身抗体）的患病率显著高于CHC患者。36%的CHC患者也存在抗核抗体、SMA和LKM-1抗体，且与疾病严重程度相关。自身抗体阳性的CHC病例在大多数肝损伤标志物和总IgG方面与AIH直接可比。与自身抗体阴性病例相比，这些病例的病程更长，但在性别、年龄或病毒载量方面没有差异。KLM-1抗体阳性的CHC病例与AIH的重叠度最高。
CHC中的自身抗体水平可能是疾病严重程度的重要标志物，阳性病例患有与AIH相似的疾病。如肝损伤标志物升高所示，自身抗体可能具有致病作用。未来的研究将揭示这两种疾病之间任何新的关联，无论是遗传方面还是其他方面。
