Richardet J P, Lons T, Johanet C, Abourached A, Raffoux C, Grimbert S, Sibony M, André C, Trinchet J C, Homberg J C
Service d'Hépato-Gastroentérologie, Hôpital Jean-Verdier, Bondy.
Gastroenterol Clin Biol. 1994;18(10):819-23.
The prevalence and significance of antiorganelle antibodies in the serum of patients with chronic hepatitis C is a subject of controversy. We studied prospectively these characteristics in patients with chronic hepatitis C.
Among 156 patients (age: 55 +/- 14 years; 83 females), 30 (19%) had significant titers of antiorganelle antibodies: anti-nuclear antibodies in 18, anti-smooth muscle antibodies in 8 (no anti-actin or anti-vimentine subtypes), anti-LKM1 in 2, type 2 anti-mitochondrial antibodies in 2 patients. Anti-organelle antibodies were not detected in 126 patients. Patients with anti-organelle antibodies were significantly older but no difference was found between the two groups for sex ratio, serum amino-transferases or gammaglobulins, histopathological liver activity or prevalence of lymphocytic sialadenitis. The presence of anti-organelle antibodies was not related to HLA phenotype, especially B8 DR3, or DR4. Response to alpha interferon, estimated by serum aminotransferase levels after six months of treatment, was the same in both groups.
These results suggest that serum anti-organelle antibodies are prevalent in during chronic hepatitis C but do not indicate a distinct autoimmune mechanism. Furthermore, the typing of anti-smooth muscle antibodies might help distinguish chronic hepatitis C from type 1 autoimmune chronic hepatitis.
慢性丙型肝炎患者血清中抗细胞器抗体的患病率及意义存在争议。我们对慢性丙型肝炎患者的这些特征进行了前瞻性研究。
156例患者(年龄:55±14岁;83例女性)中,30例(19%)抗细胞器抗体滴度显著:18例抗核抗体阳性,8例抗平滑肌抗体阳性(无抗肌动蛋白或抗波形蛋白亚型),2例抗LKM1阳性,2例患者抗线粒体2型抗体阳性。126例患者未检测到抗细胞器抗体。抗细胞器抗体阳性患者年龄显著较大,但两组在性别比例、血清转氨酶或γ球蛋白、肝脏组织病理学活性或淋巴细胞性涎腺炎患病率方面无差异。抗细胞器抗体的存在与HLA表型无关,尤其是B8 DR3或DR4。通过治疗6个月后的血清转氨酶水平评估,两组对α干扰素的反应相同。
这些结果表明,血清抗细胞器抗体在慢性丙型肝炎中普遍存在,但并不表明存在独特的自身免疫机制。此外,抗平滑肌抗体的分型可能有助于区分慢性丙型肝炎与1型自身免疫性慢性肝炎。