The dynamic and clinical significance of autoantibodies and immunoglobulins in liver transplant recipients.
The dynamic and clinical significance of autoantibodies and immunoglobulins in liver transplant recipients.
复制标题
肝移植受者自身抗体和免疫球蛋白的动态和临床意义。
DOI：
10.1111/ctr.12682
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发表时间：
2016
影响因子：
2.1
通讯作者：
Schiano,ThomasD
中科院分区：
文献类型：
--
作者：
Stanca,CarmenM;Aloman,Costica;Fiel,MariaIsabel;Raja,Kaiser;Uskudar,Oguz;Florman,Sander;Schiano,ThomasD
对于肝移植（LT）的自身抗体模式知之甚少。该研究的目的是检测终末期肝病患者在肝移植前后的自身抗体（AAB）和免疫球蛋白。在2008年10月至2011年8月期间接受肝移植后活检的肝移植患者入组。在肝移植和肝活检时评估AAB。分析了人口统计学、血清免疫球蛋白、AAB和肝脏组织学（外植体、肝移植后活检）。纳入220例患者（M/F 143/77，年龄在LT 54 (19-73)）；对76例患者进行AAB和免疫球蛋白检测。术后随访时间为285（30-1462）天。61%的患者患有丙型肝炎（HCV）；83%的患者复发HCV。术后观察到IgG、IgA、IgM（均p < 0.001）、抗心磷脂抗体IgG和IgM （p = 0.02）和β - 2微球蛋白（p = 0.004）显著降低。HCV患者LT前IgG （p = 0.005）、类风湿因子（p = 0.044）较高；IgM升高与外植体炎症增加相关（p = 0.007）。肝移植前IgG和抗平滑肌抗体水平较低的HCV复发患者比例较高（p = 0.004, p = 0.077）。综上所述，肝移植后AAB发生显著变化，且在HCV中有不同的模式。一些免疫标志物与HCV复发和外植体的晚期炎症有关。
Little is known about autoantibody pattern in liver transplantation (LT). The aim of the study was to examine autoantibodies (AAB) and immunoglobulins in patients with end‐stage liver disease before and after LT. Patients with LT who underwent post‐LT biopsies between 10/2008 and 8/2011 were enrolled. AAB were assessed at the time of LT and liver biopsy. Demographics, serum immunoglobulins, AAB, and liver histology (explant, post‐LT biopsies) were analyzed. Two hundred and twenty patients (M/F 143/77; age at LT 54 (19–73)) were included; AAB and immunoglobulins were evaluated in 76 patients. Length of follow‐up from LT was 285 (30–1462) days. Sixty‐one percent of patients had hepatitis C (HCV); 83% developed recurrent HCV. A significant decrease in IgG, IgA, IgM (p < 0.001 each), anticardiolipin antibodies IgG and IgM (p = 0.02), and beta‐2 microglobulin (p = 0.004) was observed post‐LT. HCV patients had higher IgG (p = 0.005), rheumatoid factor (p = 0.044) before LT; elevated IgM was associated with increased inflammation in the explant (p = 0.007). Lower IgG levels and antismooth muscle antibodies were present before LT in a higher percentage in patients who would develop recurrent HCV (p = 0.004, p = 0.077, respectively). In conclusion, AAB change significantly after LT and have a different pattern in HCV. Some immunological markers are associated with HCV recurrence and advanced inflammation on explant.