Łapiński Tadeusz W, Rogalska-Płońska Magdalena, Parfieniuk-Kowerda Anna, Świderska Magdalena, Flisiak Robert
Department of Infectious Diseases and Hepatology, Medical University of Białystok, Poland.
Clin Exp Hepatol. 2016 Dec;2(4):161-166. doi: 10.5114/ceh.2016.63874. Epub 2016 Nov 28.
There are reports suggesting that hepatitis C virus (HCV) may stimulate the autoimmune process. Studies have been undertaken to evaluate the occurrence and type of autoantibodies in HCV-infected patients with and without immunosuppression. Results were analyzed according to HCV genotype, intensity of inflammation and liver fibrosis stage.
The study included 105 patients chronically infected with HCV, including 25 with immunological suppression administered for kidney disease or kidney transplantation. Blood samples were tested by immunoblotting for the presence of AMA-M2, SLA/LP, LKM-1, LC1, anti-F-actin, anti-desmin, anti-myosin, anti-gp210 and anti-sp100 autoantibodies, and ANA. All the patients were scored for autoimmune hepatitis.
Autoantibodies were detected in 32.5% of patients without immunosuppression and in 16% with immunosuppression. Single types of autoantibodies were identified in 26% of patients. The most frequent ones were ANA (19%) and AMA-M2 (5.7%). The presence of antibodies in patients with genotype 1 was significantly higher in comparison to their occurrence in genotype 3. Autoimmune hepatitis was not diagnosed in any of the patients. Immunoglobulin G level was significantly higher in patients with detectable autoantibodies, compared to patients without antibodies (1.89 vs. 1.28 g/dl, < 0.001). No correlation between fibrosis stage or intensity of inflammatory state and the frequency of antibodies was found.
The antibodies are significantly more frequent in patients without immunosuppression and in patients infected with genotype 1 than genotype 3. The presence of these autoantibodies is not associated with the development of autoimmune hepatitis. Higher level of immunoglobulin G in the serum correlates with the presence of autoantibodies.
有报告表明丙型肝炎病毒（HCV）可能刺激自身免疫过程。已开展研究评估有无免疫抑制的HCV感染患者自身抗体的发生情况及类型。根据HCV基因型、炎症强度和肝纤维化阶段对结果进行分析。
该研究纳入105例慢性HCV感染患者，其中25例因肾病或肾移植接受免疫抑制治疗。通过免疫印迹法检测血样中AMA-M2、SLA/LP、LKM-1、LC1、抗F-肌动蛋白、抗结蛋白、抗肌球蛋白、抗gp210和抗sp100自身抗体以及ANA的存在情况。对所有患者进行自身免疫性肝炎评分。
无免疫抑制的患者中32.5%检测到自身抗体，有免疫抑制的患者中16%检测到自身抗体。26%的患者检测到单一类型的自身抗体。最常见的是ANA（19%）和AMA-M2（5.7%）。与基因型3的患者相比，基因型1的患者中抗体的存在显著更高。所有患者均未诊断出自身免疫性肝炎。与无抗体的患者相比，检测到自身抗体的患者免疫球蛋白G水平显著更高（1.89 vs. 1.28 g/dl，<0.001）。未发现纤维化阶段或炎症状态强度与抗体频率之间存在相关性。
无免疫抑制的患者以及感染基因型1的患者中抗体明显更常见，而感染基因型3的患者中抗体则较少见。这些自身抗体的存在与自身免疫性肝炎的发生无关。血清中较高水平的免疫球蛋白G与自身抗体的存在相关。
