Anti-Saccharomyces cerevisiae antibodies (ASCA) and autoimmune liver diseases
Anti-Saccharomyces cerevisiae antibodies (ASCA) and autoimmune liver diseases
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DOI：
10.1046/j.1365-2249.2003.02166.x
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发表时间：
2003-06-01
影响因子：
4.6
通讯作者：
Bianchi, FB
中科院分区：
文献类型：
--
作者：
Muratori, P;Muratori, L;Bianchi, FB
面包酵母酿酒酵母（ASCA）的抗体，最近提出作为克罗恩病的血清学标志物，也已在其他自身免疫性疾病中检测到。本研究的目的是确定ASCA在自身免疫性肝病中的患病率和临床意义。IgG和伊加ASCA的存在进行了评估，在215例自身免疫性肝病患者（原发性胆汁性肝硬化，PBC，123例;自身免疫性肝炎，AIH，67例;原发性硬化性胆管炎，PSC，25例），48例炎症性肠病和19例健康献血员使用市售免疫测定。间接免疫荧光法检测PSC患者抗中性粒细胞胞浆抗体（p-ANCA）。对ASCA阳性与阴性患者的主要临床及生化指标进行分析比较。ASCA在克罗恩病中占主导地位（70%）;在肝脏患者中，PSC和AMA阴性PBC的ASCA患病率最高（53%和44%）。PBC患者ASCA与伊加水平升高相关（P < 0.05）。在PSC中，ASCA或p-ANCA的检测既不与任何临床或生化特征相关，也不与潜在的炎症性肠病相关。ASCA不能被认为是自身免疫性肝病的额外血清学标志物，但应考虑在自身免疫性肝病中检测到这种反应的可能性;它们与PBC中伊加升高的相关性表明ASCA可能是粘膜免疫增强的间接标志;在PSC患者中，ASCA和p-ANCA均不能预测伴随炎症性肠病的发生。
Antibodies to the baker's yeast Saccharomyces cerevisiae (ASCA), recently proposed as a serological marker of Crohn's disease, have also been detected in other autoimmune disorders. The aim of this study was to determine prevalence and clinical significance of ASCA in autoimmune liver disease. The presence of IgG and IgA ASCA was evaluated using a commercially available immunoassay in 215 patients with autoimmune liver disease (primary biliary cirrhosis, PBC, 123 cases; autoimmune hepatitis, AIH, 67 cases; primary sclerosing cholangitis, PSC, 25 cases), 48 with inflammatory bowel disease and 19 healthy blood donors. Anti neutrophil cytoplasmic antibodies with the perinuclear pattern (p-ANCA) were assessed by indirect immunofluorescence in PSC patients. The main clinical and biochemical parameters between ASCA-positive and negative patients were analysed and compared. ASCA are predominant in Crohn's disease (70%); among liver patients, PSC and AMA-negative PBC show the highest ASCA prevalence (53% and 44%). In PBC ASCA correlate with higher levels of circulating IgA (P < 0.05). In PSC the detection of either ASCA or p-ANCA is neither associated with any clinical or biochemical feature, nor with an underlying inflammatory bowel disease. ASCA can not be considered an additional serological marker of autoimmune liver disease, but the possibility of detecting such a reactivity in autoimmune liver disorders should be considered; their correlation with elevated IgA in PBC suggests that ASCA may be an indirect sign of enhanced mucosal immunity; in PSC patients neither ASCA nor p-ANCA predict the occurrence of a concomitant inflammatory bowel disease.