Anti-ribosomal P protein: a novel antibody in autoimmune hepatitis
Anti-ribosomal P protein: a novel antibody in autoimmune hepatitis
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DOI：
10.1111/liv.12155
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发表时间：
2013-07-01
影响因子：
6.7
通讯作者：
Bonfa, Eloisa
中科院分区：
文献类型：
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作者：
Calich, Ana L.;Viana, Vilma S. T.;Bonfa, Eloisa
背景核糖体P蛋白自身抗体（抗rib P）是系统性红斑狼疮（SLE）的特异性血清学标志物，与SLE的肝脏受累有关。自身免疫性肝炎（AIH）和SLE相关性肝炎之间自身免疫背景的相似性提出了抗rib P抗体也可能与AIH相关的可能性。目的探讨抗Rib P抗体在AIH人群中的检出率及其临床意义。方法采用酶联免疫吸附试验（ELISA）检测96例AIH患者和82例健康对照者血清中抗核糖体P蛋白IgG。所有患者的血清也进行了其他狼疮特异性自身抗体的筛查，排除了抗dsDNA（n=1）和抗Sm（n=2）存在的3例患者。结果9.7%（9/93）的AIH患者血清抗Rib P抗体中、高滴度（> 40 U），而对照组中无一阳性（P=0.003）。在就诊时，有和没有抗rib P抗体的AIH患者具有相似的人口统计学/临床特征，包括肝硬化的频率（44.4%对28.5%，P=0.44），肝脏实验室检查结果（0.05）。重要的是，在最后观察时（随访期10.2 +/-4.9年），与阴性组相比，抗肋骨P抗体阳性的AIH患者肝硬化的发生率显著更高（100 vs. 60%，P=0.04）。结论在无SLE临床或实验室证据的AIH患者中发现抗rib P抗体，提示这两种疾病的共同作用机制是靶向肝脏。此外，该抗体似乎预测AIH病情加重的患者。
Background Autoantibodies to ribosomal P proteins (anti-rib P) are specific serological markers for systemic lupus erythematosus (SLE) and are associated with liver involvement in this disease. The similarity in autoimmune background between autoimmune hepatitis (AIH) and SLE-associated hepatitis raises the possibility that anti-rib P antibodies might also have relevance in AIH. Aims To evaluate the frequency and clinical significance of anti-rib P antibodies in a large AIH cohort. Methods Sera obtained at diagnosis of 96 AIH patients and of 82 healthy controls were tested for IgG anti-ribosomal P protein by ELISA. All of the sera were also screened for other lupus-specific autoantibodies, three patients with the presence of anti-dsDNA (n=1) and anti-Sm (n=2) were excluded. Results Moderate to high titres (>40U) of anti-rib P antibody were found in 9.7% (9/93) of the AIH patients and none of the controls (P=0.003). At presentation, AIH patients with and without anti-rib P antibodies had similar demographic/clinical features, including the frequency of cirrhosis (44.4 vs. 28.5%, P=0.44), hepatic laboratorial findings (0.05). Importantly, at the final observation (follow-up period 10.2 +/- 4.9years), the AIH patients with anti-rib P had a significantly higher frequency of cirrhosis compared with the negative group (100 vs. 60%, P=0.04). Conclusion The novel demonstration of anti-rib P in AIH patients without clinical or laboratory evidence of SLE suggests a common underlying mechanism targeting the liver in these two diseases. In addition, this antibody appears to predict the patients with worse AIH prognoses.