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自身抗体:它们是肝脏疾病的线索吗?

Autoantibodies: are they a clue for liver diseases?

作者信息

Nagi Salma Abdel Megeed, Ayoub Bassam Abdel Hakam, Ali Mohammed Abdel-Hafez, Elkhadry Sally Waheed, Abdallah Heba Mohamed, Rizk Marwa Sabry

机构信息

Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt.

Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Shebin El-Kom, Menoufia, Egypt.

出版信息

Clin Exp Hepatol. 2022 Dec;8(4):309-314. doi: 10.5114/ceh.2022.122275. Epub 2022 Dec 28.

Abstract

INTRODUCTION

Autoantibody testing has contributed to both biological and clinical insights in managing patients with liver disease. These autoantibodies often have clinical value for the diagnosis, disease activity and/or prognosis.

AIM OF THE STUDY

We aimed to investigate the potential application of auto-antibodies in different etiologies of non-autoimmune liver diseases.

MATERIAL AND METHODS

This study was conducted on 53 infants and children with chronic liver diseases. The patients were subjected to clinical history and examination, laboratory investigations and abdominal ultrasound. Serum of all infants and children was tested for measurement of antiprothrombin antibody and anti-b2-glycoprotein I (ab2GPI) and anticardiolipin (ACL) auto-antibodies using a fully-automated enzyme linked immunosorbent assay (ELISA) system.

RESULTS

The mean age of the infants with cholestatic liver diseases was significantly lower than those with metabolic liver diseases, hepatitis C virus (HCV) and vascular liver diseases ( < 0.05). The gender distribution was proportionate in all groups ( = 0.703). Autoantibodies showed significant variations among different etiologies of chronic liver diseases. he incidence of ab2GPI and ACL was significantly increased in both HCV (94.7% and 78.9%, respectively) and vascular liver diseases patients (90.9% and 72.7%, respectively) ( < 0.05). Antiprothrombin antibodies were found in 81.8% of vascular liver disease patients. Interestingly, all types of autoantibodies were deficient in cholestatic and metabolic liver diseases.

CONCLUSIONS

Testing for liver-related autoantibodies should be included in the workup of patients with chronic liver diseases. Further studies are needed to explain the cause-effect association of ACL, ab2GPI and antiprothrombin with chronic HCV and vascular liver diseases.

摘要

引言

自身抗体检测有助于在肝病患者管理中获得生物学和临床见解。这些自身抗体通常对诊断、疾病活动和/或预后具有临床价值。

研究目的

我们旨在研究自身抗体在不同病因的非自身免疫性肝病中的潜在应用。

材料与方法

本研究对53例患有慢性肝病的婴幼儿和儿童进行。对患者进行临床病史采集、检查、实验室检查和腹部超声检查。使用全自动酶联免疫吸附测定(ELISA)系统检测所有婴幼儿和儿童血清中的抗凝血酶原抗体、抗β2糖蛋白I(ab2GPI)和抗心磷脂(ACL)自身抗体。

结果

胆汁淤积性肝病患儿的平均年龄显著低于代谢性肝病、丙型肝炎病毒(HCV)和血管性肝病患儿(P<0.05)。所有组的性别分布均衡(P = 0.703)。自身抗体在慢性肝病的不同病因之间存在显著差异。HCV患者(分别为94.7%和78.9%)和血管性肝病患者(分别为90.9%和72.7%)中ab2GPI和ACL的发生率显著升高(P<0.05)。81.8%的血管性肝病患者发现有抗凝血酶原抗体。有趣的是,胆汁淤积性和代谢性肝病患者中所有类型的自身抗体均缺乏。

结论

慢性肝病患者的检查应包括检测肝脏相关自身抗体。需要进一步研究来解释ACL、ab2GPI和抗凝血酶原与慢性HCV和血管性肝病之间的因果关系。

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