Antinuclear and Pancreatic Acinar Cell Antibodies in Pancreatic Diseases

Abstract

Recently, the presence of acinar cell antibodies (ACA) and antinuclear antibodies (ANA) in acute and/or chronic pancreatitis have been discussed in the light of an immunological pathogenesis of pancreatitis. In the present study sera of 109 patients with pancreatic diseases were scanned for ACA and ANA which were found in 5 and 16 patients, respectively. The frequency of ACA and ANA was similar in patients with pancreatitis of known and unknown aetiology. In conclusion, the presence of ACA and ANA seems to be rather an epiphenomenon than an index for a certain immunological aetiology of pancreatitis.

Recent concept of autoimmune-related pancreatitis

“…1 Since Sarles et al 2 observed a case of pancreatitis associated with hypergammaglobulinemia, the occasional coexistence of pancreatitis with other autoimmune diseases, such as Sjögren's syndrome (SjS), 3 primary sclerosing cholangitis (PSC), 4,5 and primary biliary cirrhosis (PBC) 4 has been reported. These findings support the hypothesis that an autoimmune mechanism may be involved in the pathogenesis and pathophysiology of pancreatitis in some patients, [6][7][8][9][10][11][12][13][14][15][16] which leads us to the concept of an autoimmune-related pancreatitis (AIP), 15 the so-called "autoimmune pancreatitis." 8 Although it has not been widely accepted as a new clinical entity, the present review discusses the recent concept of AIP from the clinical and animal experimental aspects.…”

Antitissue Antibodies in Chronic Pancreatitis

“…Our results, unlike those reported by oth ers [5], showed a high number of positive sera for AA in CP. This discrepancy could be explained by the higher number of different AA that were checked in our series of pa tients.…”

“…There are scanty and conflicting reports about the presence of AA in sera of patients with a well-documented CP [4,5], In our study AA were found with the same frequence in CP as well as in LC. in which AA have been commonly described [10][11][12], In both the dis eases we observed a significant occurrence of AA compared to healthy subjects.…”

“…Few papers deal with the presence of AA in sera of patients affected by chronic pancreatitis (CP), a pro gressive disease with several unsolved etiopathogenetical problems [2], Antipancreatic acinar cell antibodies (ACA) have been found in the recovery phase of acute pancreatitis and they seemed strongly related to this form of the disease [3], ACA and antinuclear anti bodies have been found in patients affected both by acute and CP of different etiology and questions have been raised about their clini cal significance [4,5]. At present, very little is known about a complete pattern of AA in patients affected by CP.…”

Ultrasonographic evaluation in patients with autoimmune-related pancreatitis

“…1 A proportion of cases labeled "idiopathic" probably represent autoimmune-mediated disease. [2][3][4] Sarles et al 5,6 first reported cases of pancreatitis associated with hypergammaglobulinemia. The concept of autoimmune-related pancreatitis (AIP) was originally proposed by Yoshida et al 7 and reviewed by Okazaki et al 8 and Okazaki and Chiba; 9 and the following characteristics have been described: [7][8][9][10][11][12][13] (1) diffuse enlargement of the pancreas and irregular narrowing of the main pancreatic duct (MPD); (2) increased levels of serum immunoglobulin G (IgG) and the presence of some autoantibodies; (3) asymptomatic or minimal symptoms, such as epigastralgia or back pain, compared to ordinary alcoholic chronic pancreatitis; (4) histologically, fibrotic changes with lymphocyte infiltration around the pancreatic ducts; and (5) good response to steroid therapy.…”