Studies on autoimmune hepatitis type, I,II,III,and IV

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Recently, autoantibodies specific for liver diseases were identified and European investigators attempted to classify autoimmune hepatitis (AIH) into 4 groups by autoantibodies. The aims of the present study are to investigate the frequency and significance of seropositivity of such autoantibodies in Japanese patients with chronic liver diseases.1.Antibodies to liver/kidney microsomal type 1 (anti-LKM1) which was proposed as a maker of AIH type II was found in 2.5% of patients with chronic hepatitis C,but not in other patients including various liver diseases. There were no obvious differences in age, sex ratio and laboratory findings comparing to those with patients with chronic hepatitis C negative for anti-LKM1. Patients with chronic hepatitis C positive for anti-LKM1 were treated with interferon alpha. Interestingly, complete response was found in patients having mutations in the NS5A gene of hepatitis C virus 1b geno type, suggesting that a correlation between responses to interfe … More ron and mutation in NS5A gene presents even in patients positive for anti-LKM1. No patients of AIH positive for anti-LKM1 were found in the present study, except for one case from Osaka City University, indicating that AIH type lla is very rare in Japan.2.Antibodies to soluble liver antigens (anti-SLA) were found in 6% of patients with AIH.Anti-SLA seems to be unique in liver disease because of its absence in other diseases except for liver disease. In immunoblotting analysis, sera positive for anti-SLA reacted to several proteins including molecular masses of 45 and 52KD,but its heterogeneity was found.3.Patients with chronic hepatitis positive for high titers of SMA more than 1 : 160 dilution were found in 16 out of 358 patients. Interestingly, 10% of chronic hepatitis non A,B and C were soropositive for SMA.Those patients seem to be AIH type III.ConclusionIn Japan, AIH is common, but AIH II,III and IV are rarely present. However AIH patients negative for ANA can be found in our clinics. Further observations are needed to establish the early diagnosis and treatment for these patients. Less