Autoantibodies by Line Immunoassay in Patients With Primary Biliary Cirrhosis

Abstract

: Objectives : We attempted to measure multiple autoantibodies simultaneously using line immunoassay (LIA) in patients with primary biliary cirrhosis (PBC) with or without anti -mitochondrial antibody (AMA) and patients with PBC -autoimmune hepatitis (AIH) overlap, and we examined the clinical significance of measuring these autoantibodies. Methods : The study population consisted of 80 patients with PBC (including 12 AMA -negative patients), 16 patients with PBC -AIH overlap and 40 patients with AIH as controls. Nine antibodies (AMA -M2, M2 -3E, Sp100, PML, gp210, Ro -52, LKM -1, LC -1 and SLA/LP) were detected by LIA, and AMA -M2 and anti -centromere antibody (ACA) were detected by ELISA. We examined the relationship between these autoantibodies and clinical findings. Results : The positive prevalence of each autoantibody and ACA in the PBC group, as determined by LIA, was as follows : 13.8% for anti -Sp100, 8.7% for anti -PML, 40% for anti -gp210 and 27.5% for anti -Ro -52 antibodies and 32.5% for ACA. In the PBC -AIH overlap group, the prevalence of anti -gp210 antibody (68.7%) and that of anti -Ro -52 antibody (81.2%) were significantly higher than those in the PBC and AIH groups. Only a few patients were positive for 2 or more autoantibodies. Nine patients were determined to be negative for all autoantibodies by LIA, of whom 7 were positive for ACA. Patients positive for anti -gp210 antibody included more patients classified as stage 4 on histology than did the negative group. Those positive for ACA included more patents with varices than did the negative group. Conclusion : LIA can measure multiple autoantibodies simultaneously and thus is considered useful in diagnosing PBC and PBC -AIH overlap. In addition, ACA is a useful marker for identifying AMA -negative PBC.

Meta-Analysis Assessment of GP210 and SP100 for the Diagnosis of Primary Biliary Cirrhosis

“…A total of 24 articles were excluded for the following reasons: 13 had no direct link with the main subject; three were reviews; six had incomplete results data, and one duplicated reports from the same study population. The remaining 31 articles [4]–[10], [12]–[35], including 25 [4]–[6], [9]–[10], [12]–[15], [17]–[23], [26], [28]–[35] on GP210 and 21 [4], [6]–[10], [12], [14]–[25], [27], [29] on SP100 (15 [4], [6], [9], [10], [12], [14], [15], [17]–[23], [29] articles reported both GP210 and SP100), were incorporated into the meta-analysis.…”

“…A total of 25 studies on GP210 (19 studies in English [4], [5], [9], [10], [12], [13], [18]–[21], [26], [28]–[35] and six in Chinese [6], [14], [15], [17], [22], [23]) were published between 1988 and 2013 (Table 1), and involved a total of 2,806 PBC patients and 7,494 controls. Of these 25 studies, 15 were carried out in Asia [5], [6], [9], [12]–[15], [17], [19], [20], [22], [23], [29], [31], [33], five in Europe [10], [28], [30], [32], [35], and five in South America [4], [18], [21], [26], [34]; 56% (14 of 25) using immunoblotting and 48% (12 of 25) with the ELISA method (one article [26] was conducted using two methods). A total of 21 studies on SP100 (13 in English [4], [8], [9], [10], [12], [18]–[21], [24], [25], [27], [29] and eight in Chinese [6], [7], [14]–[17], [22], [23]) were published between 1990 and 2013 (Table 1...…”

“…Of these 25 studies, 15 were carried out in Asia [5], [6], [9], [12]–[15], [17], [19], [20], [22], [23], [29], [31], [33], five in Europe [10], [28], [30], [32], [35], and five in South America [4], [18], [21], [26], [34]; 56% (14 of 25) using immunoblotting and 48% (12 of 25) with the ELISA method (one article [26] was conducted using two methods). A total of 21 studies on SP100 (13 in English [4], [8], [9], [10], [12], [18]–[21], [24], [25], [27], [29] and eight in Chinese [6], [7], [14]–[17], [22], [23]) were published between 1990 and 2013 (Table 1), and comprised a total of 2,140 cases and 6,976 controls. Of those studies, 13 were conducted in Asia [6], [7], [9], [14]–[17], [19], [20], [22], [23], [29], five were conducted in Europe [8], [10], [24], [25], [27], and three were conducted in South America [4], [18], [2...…”

“…A total of 21 studies on SP100 (13 in English [4], [8], [9], [10], [12], [18]–[21], [24], [25], [27], [29] and eight in Chinese [6], [7], [14]–[17], [22], [23]) were published between 1990 and 2013 (Table 1), and comprised a total of 2,140 cases and 6,976 controls. Of those studies, 13 were conducted in Asia [6], [7], [9], [14]–[17], [19], [20], [22], [23], [29], five were conducted in Europe [8], [10], [24], [25], [27], and three were conducted in South America [4], [18], [21]; 47.6% (10 of 21) using immunoblotting and 52.4% (11 of 21) with the ELISA method.…”

“…Among these, two subtypes of ANA, one that recognizes nuclear pore membrane protein gp210 (GP210) and another against nuclear body protein sp100 (SP100), have been reported to have a sensitivity of 15–40% [4]–[6] and 20–40% [4], [7], [8], respectively, whereas specificities of both GP210 and SP100 to PBC are greater than 95% [4], [5], [9]. Conversely, while AMAs are not associated with disease progression, ANAs are associated with disease severity and clinical outcome, and are therefore markers of poor prognosis [5], [10]–[13].…”