Identification of a Novel Antibody Associated with Autoimmune Pancreatitis

Frulloni, Luca; Lunardi, Claudio; Simone, Rita; Dolcino, Marzia; Scattolini, C.; Falconi, Massimo; Benini, Luigi; Vantini, Italo; Corrocher, Roberto; Puccetti, Antonio

doi:10.1056/nejmoa0903068

Cited by 331 publications

(231 citation statements)

References 24 publications

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“…However, they did not confirm that the IgG subclass of those antigens was IgG4. In contrast, Frulloni et al demonstrated that the antibodies against an amino acid sequence of plasminogen-binding protein of Helicobacter pylori were frequently found in the sera of autoimmune pancreatitis, although this interesting finding has not yet been confirmed by others [32]. Similarly, we previously showed the possibility of involvement of Mycobacterium tuberculosis in the pathogenesis of IgG4-RD [33].…”

Section: Detection Of Identical or Genetically Related Clones Betweencontrasting

confidence: 65%

Analysis of IgG4-positive clones in affected organs of IgG4-related disease

Kakuchi

Yamada

Ito

et al. 2016

Modern Rheumatology

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Objective. We investigated class switch reaction (CSR) in affected organs and evaluated whether the same or genetically related clones exist in IgG4-RD.Methods. We studied three patients with IgG4-RD. Total cellular RNA was extracted from salivary glands and peripheral blood, and lung tissue. Activation-induced cytidine deaminase (AID) and immunoglobulin heavy chain third complementarity determining region (IgVH-CDR3) of IgM and IgG4 were detected by reverse transcription polymerase chain reaction. We analyzed the clonal relationship of infiltrating IgG4-positive cells, as compared with IgM. We determined the existence of common clones among organs and patients.Result. AID was expressed in salivary glands of all patients and lung tissue in one. Closely Conclusion. Our results demonstrate the existence of common antigen(s) shared by patients with IgG4-RD.

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Section: Detection Of Identical or Genetically Related Clones Betweencontrasting

confidence: 65%

Analysis of IgG4-positive clones in affected organs of IgG4-related disease

Kakuchi

Yamada

Ito

et al. 2016

Modern Rheumatology

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“…Immunoglobulin G-4 disease represents a unique inflammatory condition that induces tumorous swelling of affected organs, histologically characterized with diffuse lymphoplasmacytic infiltration of affected organ, occasional eosinophils, storiform fibrosis, obliterative phlebitis, infiltration by numerous IgG4-bearing plasma cells, and marked clinically by dramatic response to steroid therapy [53]. Autoimmune pancreatitis (AIP) seems to be the prototype of an IgG4-related disease, suggesting that gastric H. pylori infection triggers AIP in genetically predisposed individuals through molecular mimicry with plasminogen-binding protein of H. pylori exhibiting homology to ubiquitin-protein ligase E3 component n-recognin 2, an enzyme expressed in pancreatic acinar cells [54]. However, serum IgG4 levels were elevated in only 53% of patients in the mentioned study, suggesting that the cohort assessed might, in substantial part, represent non-IgG4-related AIP (type II AIP).…”

Section: Ophthalmology Skin and Oral Mucosa Diseasesmentioning

confidence: 99%

Extragastric Manifestations of Helicobacter pylori Infection

et al. 2012

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In the last year, different diseases possibly linked to Helicobacter pylori infection but localized outside of the stomach have been investigated. There are, in fact, several studies concerning cardiovascular diseases, hematologic disorders, neurologic diseases, metabolic, hepatobiliary diseases, and other conditions. Some of those studies, such as those on sideropenic anemia and idiopathic thrombocytopenic purpura, are quite large and well conducted, while in other cases there are just small or isolated studies or even case reports. Nonetheless, there is much interest among researchers all over the world for such a topic as demonstrated by the large number of studies published in the last year.Several articles have been published in the last year concerning the extragastric manifestations of Helicobacter pylori infection. Here we summarize the main results obtained by these studies.

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“…Frulloni L et al reported a novel serologic marker of AIP, antibodies against plasminogenbinding protein (Anti-PBP) peptide, which was present in 94% of AIP patients and in no health controls. However, in this study, these Anti-PBP peptide antibodies were also present in 5% of the patients with PC [12]. The most significant finding on an ERCP or magnetic resonance cholangiopancreatography (MRCP) includes a diffuse, irregular narrowing of the pancreatic duct; a narrowed main and dorsal pancreatic duct, or a focal stricture of the pancreatic duct [13].…”

Section: Discussionmentioning

confidence: 52%

Autoimmune Pancreatitis Presenting as a Focal Pancreatic Mass Mimicking Pancreatic Cancer: A Case Report and Review of the Literature

Chintanaboina

2012

J Med Cases

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A 68-year-old female presented with a 2-week history of jaundice, generalized itching and weight loss in 2006. On physical examination, she was deeply jaundiced; however, other clinical examinations were completely unremarkable. Liver function tests (LFTs) were deranged: serum alkaline phosphatase 407 U/L (35 -104), serum aspartate transaminase 57 U/L (0 -31), serum alanine transaminase 184 U/L (0 -37), and serum total bilirubin 4.3 mg/dL (0 -1). Abdominal CT revealed a 4.8 cm × 3.5 cm mass in the pancreatic head. ERCP revealed a high-grade stricture in the distal CBD. An internal biliary stent was placed in to the CBD stricture. Patient's symptoms relieved after biliary stenting. Serum CA 19-9 was elevated at 1,568 U/mL (0 -37). Due to high suspicion for pancreatic cancer, patient underwent pylorus-sparing pancreaticoduodenectomy. Histopathology was benign and showed perilobular lymphoplasmacytic infiltrate, periductal fibrosis and phlebitis that was consistent with autoimmune pancreatitis. Patient was started on oral prednisone that was eventually replaced with azathioprine. Serum IgG4 was 53 mg/dL (1 -291) after starting steroid treatment.

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Identification of a Novel Antibody Associated with Autoimmune Pancreatitis

Abstract: The antibody that we identified was detected in most patients with autoimmune pancreatitis but also in some patients with pancreatic cancer, making it an imperfect test to distinguish between these two conditions.

Cited by 331 publications

References 24 publications

Analysis of IgG4-positive clones in affected organs of IgG4-related disease

Analysis of IgG4-positive clones in affected organs of IgG4-related disease

Extragastric Manifestations of Helicobacter pylori Infection

Autoimmune Pancreatitis Presenting as a Focal Pancreatic Mass Mimicking Pancreatic Cancer: A Case Report and Review of the Literature

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