Triger D R, Charlton C A, Ward A M
Gut. 1982 Oct;23(10):814-8. doi: 10.1136/gut.23.10.814.
In a prospective survey positive antimitochondrial antibodies have been detected in 69/4200 (1.64%) of all sera submitted to a routine immunology laboratory. Of the 69, only nine patients had uniquivocal primary biliary cirrhosis, six others had chronic active hepatitis, 10 had abnormal liver function tests without evidence of primary biliary cirrhosis, while the remaining 44 had no clinical or biochemical evidence of liver disease. Outside the context of liver disease antimitochondrial antibodies were observed with similar frequency in patients with autoimmune disorders as in other conditions. It was not possible to distinguish primary biliary cirrhosis from patients without liver disease by antibody titre or by immunoglobulin subclass. The positive antimitochondrial antibody patients without liver disease were uniformly distributed throughout the city of Sheffield, in contrast with the marked clustering of cases of primary biliary cirrhosis. We conclude that, in the absence of clinical liver disease, the antimitochondrial antibody test alone (as detected by routine immunofluorescent techniques) does not appear to be a specific screening test for primary biliary cirrhosis. While we cannot exclude the possibility that the autoantibody indicates a predisposition to develop primary biliary cirrhosis, further prospective studies are needed to determine which patients will progress in this manner. The possibility that environmental factors may be implicated cannot be discounted.
在一项前瞻性调查中，提交至一家常规免疫学实验室的4200份血清样本中，检测出69份（1.64%）抗线粒体抗体呈阳性。在这69例中，仅有9例明确诊断为原发性胆汁性肝硬化，另外6例患有慢性活动性肝炎，10例肝功能检查异常但无原发性胆汁性肝硬化证据，其余44例无肝病的临床或生化证据。在非肝病背景下，自身免疫性疾病患者中抗线粒体抗体的检出频率与其他情况相似。无法通过抗体滴度或免疫球蛋白亚类将原发性胆汁性肝硬化患者与无肝病患者区分开来。与原发性胆汁性肝硬化病例明显聚集不同，无肝病的抗线粒体抗体阳性患者在谢菲尔德市分布均匀。我们得出结论，在无临床肝病的情况下，仅抗线粒体抗体检测（通过常规免疫荧光技术检测）似乎并非原发性胆汁性肝硬化的特异性筛查试验。虽然我们不能排除自身抗体表明有发生原发性胆汁性肝硬化倾向的可能性，但需要进一步的前瞻性研究来确定哪些患者会以这种方式发展。不能忽视环境因素可能起作用的可能性。
