Wiedmann K H, Melms A, Berg P A
Liver. 1983 Dec;3(6):369-76. doi: 10.1111/j.1600-0676.1983.tb00890.x.
Using a sensitive fluoroimmunoassay, anti-actin antibodies (AA) of the IgM and IgG classes were measured in 240 patients with various chronic liver diseases and in 211 patients with non-hepatic autoimmune muscle, heart, malignant and inflammatory bowel diseases. Thirty-two out of 40 patients (80%) with autoimmune chronic active hepatitis (CAH) had AA only of the IgG class (geom. mean X = 1.78, SEM +/- 0.07) and only three patients (8%) had both IgG and IgM AA, the latter in lower titres. In patients with primary biliary cirrhosis (PBC) and AMA-positive cholestatic CAH, AA of both IgM and IgG classes were equally represented (60% IgG and 64% IgM AA in PBC, 73% IgG and 51% IgM AA in cholestatic CAH) but the titres were very low (geom. mean IgG AA in PBC 1.035, SEM +/- 0.03, in cholestatic CAH 1.18, SEM +/- 0.02). In contrast to autoimmune (lupoid) CAH, AA were rare in HBsAg positive CAH (9/43, 21%) and only present in low titres. However, in six out of 21 patients with anti-HBs and anti-HBc-positive chronic active hepatitis, high AA of IgG class were found, suggesting the autoimmune type of liver disease. In NANB virus-induced chronic liver disease after blood transfusion, AA were only occasionally found (IgG antibodies 1/19, IgM antibodies 3/19) and none were found in the eight patients with sporadic NANB hepatitis. They were also rare in 30 patients with alcoholic liver disease (3/30, 10%).(ABSTRACT TRUNCATED AT 250 WORDS)
采用灵敏的荧光免疫测定法,检测了240例各种慢性肝病患者以及211例非肝脏自身免疫性肌肉、心脏、恶性和炎症性肠病患者的IgM和IgG类抗肌动蛋白抗体(AA)。40例自身免疫性慢性活动性肝炎(CAH)患者中有32例(80%)仅具有IgG类AA(几何平均数X = 1.78,标准误±0.07),只有3例患者(8%)同时具有IgG和IgM AA,后者滴度较低。在原发性胆汁性肝硬化(PBC)和AMA阳性胆汁淤积性CAH患者中,IgM和IgG类AA的比例相当(PBC中IgG AA占60%,IgM AA占64%;胆汁淤积性CAH中IgG AA占73%,IgM AA占51%),但滴度非常低(PBC中IgG AA的几何平均数为1.035,标准误±0.03;胆汁淤积性CAH中为1.18,标准误±0.02)。与自身免疫性(狼疮样)CAH相反,AA在HBsAg阳性的CAH中很少见(9/43,21%),且仅以低滴度存在。然而,在21例抗-HBs和抗-HBc阳性的慢性活动性肝炎患者中有6例发现了高滴度的IgG类AA,提示为自身免疫性肝病类型。在输血后由非甲非乙型病毒引起的慢性肝病中,仅偶尔发现AA(IgG抗体1/19,IgM抗体3/19),在8例散发性非甲非乙型肝炎患者中未发现AA。它们在30例酒精性肝病患者中也很少见(3/30,10%)。(摘要截短于250字)