Zeng Xiang-Peng, Liu Ting-Ting, Hao Lu, Xin Lei, Wang Teng, He Lin, Pan Jun, Wang Dan, Bi Ya-Wei, Ji Jun-Tao, Liao Zhuan, Du Ting-Ting, Lin Jin-Huan, Zhang Di, Guo Hong-Lei, Chen Hui, Zou Wen-Bin, Li Bai-Rong, Cong Zhi-Jie, Wang Li-Sheng, Xu Zheng-Lei, Xie Ting, Liu Ming-Hao, Deng An-Mei, Li Zhao-Shen, Hu Liang-Hao
Department of Gastroenterology, Gongli Hospital, The Second Military Medical University, Shanghai, China.
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China.
BMC Gastroenterol. 2019 Feb 14;19(1):31. doi: 10.1186/s12876-019-0947-7.
Autoimmune factor was regarded as one of the risk factors in the pathogenesis of chronic pancreatitis (CP), especially for autoimmune pancreatitis (AIP). However, whether autoimmune factor plays a role in non-AIP CP or not was unknown.
Hospitalized patients with non-AIP CP from January 2010 to October 2016 were detected for 22 autoantibodies at the time of hospital admission. Autoantibodies with frequency > 0.5% were enrolled to calculate the frequency in historial healthy controls through literature search in PubMed. Differentially expressed autoantibodies were determined between patients and historial healthy controls, and related factors were identified by multivariate logistic regression analysis.
In a total of 557 patients, 113 cases were detected with 19 kinds of positive autoantibodies, among them anti-β2-glycoprotein I (β2-GPI) antibody was most frequent (9.16%). Compared with historial healthy controls, the frequencies of serum β2-GPI and anti SS-B antibody in patients were significantly higher, while frequencies of anti-smooth muscle antibody and anticardiolipin antibody were significantly lower (all P < 0.05). Multivariate logistic regression analysis result showed that diabetes mellitus (OR = 2.515) and common bile duct stricture (OR = 2.844) were the risk factors of positive β2-GPI antibody in patients while diabetes mellitus in first-/second-/third-degree relatives (OR = 0.266) was the protective factor. There were no related factors for other three differentially expressed autoantibodies.
Four autoantibodies were expressed differentially between patients with non-AIP CP and historial healthy controls. Due to limited significance for diagnosis and treatment of chronic pancreatitis, autoantibodies detection is not recommended conventionally unless suspected of AIP.
自身免疫因素被视为慢性胰腺炎（CP）发病机制中的危险因素之一，尤其是自身免疫性胰腺炎（AIP）。然而，自身免疫因素在非AIP型CP中是否起作用尚不清楚。
对2010年1月至2016年10月住院的非AIP型CP患者在入院时检测22种自身抗体。将频率>0.5%的自身抗体纳入，通过在PubMed上检索文献来计算历史健康对照中的频率。确定患者与历史健康对照之间差异表达的自身抗体，并通过多因素逻辑回归分析确定相关因素。
总共557例患者中，113例检测出19种自身抗体阳性，其中抗β2-糖蛋白I（β2-GPI）抗体最为常见（9.16%）。与历史健康对照相比，患者血清β2-GPI和抗SS-B抗体的频率显著更高，而抗平滑肌抗体和抗心磷脂抗体的频率显著更低（均P < 0.05）。多因素逻辑回归分析结果显示，糖尿病（OR = 2.515）和胆总管狭窄（OR = 2.844）是患者β2-GPI抗体阳性的危险因素，而一级/二级/三级亲属中有糖尿病（OR = 0.266）是保护因素。其他三种差异表达的自身抗体无相关因素。
非AIP型CP患者与历史健康对照之间有四种自身抗体差异表达。由于对慢性胰腺炎的诊断和治疗意义有限，除非怀疑为AIP，通常不建议常规检测自身抗体。
