Frequency and significance of antibodies to cyclic citrullinated peptide in type 1 autoimmune hepatitis
Frequency and significance of antibodies to cyclic citrullinated peptide in type 1 autoimmune hepatitis
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DOI：
10.1080/08916930600783348
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发表时间：
2006-06-01
期刊：
影响因子：
3.5
通讯作者：
Norman, Gary L.
中科院分区：
文献类型：
--
作者：
Montano-Loza, Aldo;Czaja, Albert J.;Norman, Gary L.
目的：探讨抗环瓜氨酸多肽抗体在1型自身免疫性肝炎患者中的出现频率、临床表型及预后意义。方法：采用酶联免疫吸附试验检测395例自身免疫性肝炎患者血清中抗环瓜氨酸多肽抗体，检测结果与临床及组织学特征、HLADR3、DR4频率及治疗结果相关。血清阳性与类风湿性关节炎(RA)的高发生率相关(25vs.0%，P<；0.001)。与血清阴性患者相比，抗环瓜氨酸多肽抗体阳性患者发病时的组织学硬化发生率(47%比20%，P=0.01)和死于肝功能衰竭的患者(25%比9%，P=0.04)也显著增加。抗环瓜氨酸肽抗体阳性患者和RA患者发病时的肝硬变发生率分别为100%和21%(P=0.005)。结论：抗环瓜氨酸多肽抗体存在于1型自身免疫性肝炎患者中，这些患者发病时有更高的肝硬变发生率和死于肝功能衰竭。他们合并RA是肝硬化亚组的特征。
Objectives: Determine the frequency, clinical phenotype, and prognostic implications of antibodies against cyclic citrullinated peptides in patients with type 1 autoimmune hepatitis.Methods: Three hundred and ninety-five serum samples from 179 patients were tested by enzyme-linked immunosorbent assay, and findings correlated with clinical and histological features, frequency of HLA DR3 and DR4, and treatment outcome.Results: Twenty patients (11%) had antibodies against cyclic citrullinated peptides. Seropositivity was associated with a higher frequency of rheumatoid arthritis (RA) (25 vs. 0%, P < 0.001). Patients with antibodies against cyclic citrullinated peptides also had a significantly greater occurrence of histological cirrhosis at presentation (47 vs. 20%, P = 0.01) and death from hepatic failure than seronegative patients (25 vs. 9%, P = 0.04). Cirrhosis at presentation occurred more commonly in the patients with antibodies against cyclic citrullinated peptides and RA than in the other patients (100 vs. 21%, P = 0.005).Conclusions: Antibodies against cyclic citrullinated peptides occur in a subgroup of patients with type 1 autoimmune hepatitis who have a greater occurrence of cirrhosis at presentation and death from hepatic failure. Their presence with RA at accession characterizes a subgroup with cirrhosis.