First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
Dig Liver Dis. 2017 Sep;49(9):947-956. doi: 10.1016/j.dld.2017.06.010. Epub 2017 Jun 23.
The progressively growing knowledge of the pathophysiology of a number of immune-mediated gastrointestinal and liver disorders, including autoimmune atrophic gastritis, coeliac disease, autoimmune enteropathy, inflammatory bowel disease, autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis and autoimmune pancreatitis, together with the improvement of their detection methods have increased the diagnostic power of serum antibodies. In some cases - coeliac disease and autoimmune atrophic gastritis - they have radically changed gastroenterologists' diagnostic ability, while in others - autoimmune hepatitis, inflammatory bowel disease and autoimmune pancreatitis - their diagnostic performance is still inadequate. Of note, serum antibody misuse in clinical practice has raised a number of controversies, which may generate confusion in the diagnostic management of the aforementioned disorders. In this review, we critically re-evaluate the usefulness of serum antibodies as biomarkers of immune-mediated gastrointestinal and liver disorders, and discuss their pitfalls and merits.
随着对多种免疫介导的胃肠道和肝脏疾病（包括自身免疫性萎缩性胃炎、乳糜泻、自身免疫性肠炎、炎症性肠病、自身免疫性肝炎、原发性硬化性胆管炎、原发性胆汁性胆管炎和自身免疫性胰腺炎）的病理生理学认识的不断深入，以及检测方法的改进，血清抗体的诊断能力得到了提高。在某些情况下（乳糜泻和自身免疫性萎缩性胃炎），它们彻底改变了胃肠病学家的诊断能力，而在其他情况下（自身免疫性肝炎、炎症性肠病和自身免疫性胰腺炎），其诊断性能仍不足。值得注意的是，血清抗体在临床实践中的滥用引发了许多争议，这可能会导致上述疾病的诊断管理产生混淆。在这篇综述中，我们批判性地重新评估了血清抗体作为免疫介导的胃肠道和肝脏疾病生物标志物的有用性，并讨论了它们的缺陷和优点。
