Anti-Saccharomyces cerevisiae as unusual antibodies in autoimmune hepatitis.
Anti-Saccharomyces cerevisiae as unusual antibodies in autoimmune hepatitis.
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发表时间：
2009-03
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通讯作者：
S. Fagoonee;L. Deluca;C. DeAngelis;A. Castelli;M. Rizzetto;R. Pellicano
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作者：
S. Fagoonee;L. Deluca;C. DeAngelis;A. Castelli;M. Rizzetto;R. Pellicano
自身抗体是自身免疫性肝炎（AIH）的疾病标志物。抗核抗体、平滑肌抗体、抗肝/肾微粒体1型抗体和抗中性粒细胞胞质核周抗体构成了自身抗体的“常规"组合，而评估新的自身抗体作为诊断或预后标志物（如抗酿酒酵母抗体）的新兴趣是可检测的（ASCA）。本文主要集中在研究结果和ASCA在AIH中的潜在作用。这些抗体存在于5-6.3%的献血者和胃肠道环境中，ASCA最常在克罗恩病中发现，在溃疡性结肠炎和乳糜泻过程中频率较低。此外，在原发性硬化性胆管炎、原发性胆汁性肝硬化和AIH患者中也有报道。20-30%的AIH患者发生ASCA，仅在1型AIH中观察到IgG ASCA的统计学显著增加。这可能表明对原发性致病过程的间接免疫反应。肝炎的结果不受ASCA存在的影响。结论：ASCA阳性并不意味着AIH患者存在一个独特的亚群，这些自身抗体不参与AIH的发病机制。
Autoantibodies are disease markers of autoimmune hepatitis (AIH). Antinuclear antibodies, smooth muscle antibodies, antibodies to liver/kidney microsome type 1, and perinuclear antibodies to neutrophil cytoplasm constitute the ''conventional'' battery of autoantibodies, while an emerging interest to evaluate new autoantibodies as diagnostic or prognostic markers, such as the anti-Saccharomyces cerevisiae antibodies, is detectable (ASCA). This paper focuses mainly on the findings and the potential role of ASCA in AIH. These antibodies are present in 5-6.3% of blood donors and in the gastrointestinal setting, ASCA have been found most often in Crohn's disease and with lower frequency in the course of ulcerative colitis and celiac disease. Furthermore, they have been described, to a lesser extent, in patients with primary sclerosing cholangitis and primary biliary cirrhosis and in AIH. ASCA occur in 20-30% of patients suffering from AIH with a statistically significant increase observed only for IgG ASCA in type 1 AIH. This probably indicates collateral immune reactivities to the primary pathogenic process. The outcome of hepatitis is not influenced by the presence of ASCA. In conclusion, ASCA positivity does not imply that there exists a distinct subgroup of patients with AIH and these autoantibodies are not involved in the pathogenetic mechanism of AIH.