Antibodies to SS-A/Ro-52kD and centromere in autoimmune liver disease: a clue to diagnosis and prognosis of primary biliary cirrhosis.

  • Granito A
  • Muratori P
  • Muratori L
 et al. 
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Abstract

BACKGROUND: Primary biliary cirrhosis (PBC) may be associated with various rheumatological disorders.

AIM: To investigate the frequency and significance of 'rheumatological' antinuclear antibodies in the field of autoimmune chronic liver disease, with special regard to PBC.

METHODS: We studied 105 patients with PBC, 162 autoimmune liver disease controls (type 1 and 2 autoimmune hepatitis, primary sclerosing cholangitis), 30 systemic lupus erythematosus and 50 blood donors. Sera were tested for the presence of antibodies to extractable nuclear antigens (anti-ENA) by counterimmunoelectrophoresis, enzyme-linked and immunoblot (IB) assay, and for the presence of anti-centromere antibodies (ACA) by indirect immunofluorescence on HEp-2 cells and IB.

RESULTS: The overall prevalence of IB-detected anti-ENA in PBC (30%) was higher than in type 1 autoimmune hepatitis (2.5%, P < 0.0001), type 2 autoimmune hepatitis (0%, P < 0.0001) and primary sclerosing cholangitis (11.5%, P = 0.006) and lower than in systemic lupus erythematosus (53%, P = 0.03). The most frequent anti-ENA reactivity in PBC was anti-SSA/Ro-52kD (28%). ACA were detected by IB in 21% PBC patients and never in the other subjects (P < 0.0001). Anti-SS-A/Ro/52kD positive PBC patients had at the time of diagnosis a more advanced histological stage (P = 0.01) and higher serum levels of bilirubin (P = 0.01) and IgM (P = 0.03) compared with negative ones.

CONCLUSIONS: In the autoimmune liver disease setting, anti-SS-A/Ro-52kD and ACA have a high specificity for PBC and can thus be of diagnostic relevance in anti-mitochondrial antibodies negative cases. If confirmed in further studies with adequate follow-up, anti-SS-A/Ro-52kD antibodies might identify PBC patients with a more advanced and active disease.

Author-supplied keywords

  • 80 and over
  • Adult
  • Aged
  • Antibodies
  • Antinuclear
  • Antinuclear: blood
  • Autoimmune Diseases
  • Autoimmune Diseases: diagnosis
  • Autoimmune Diseases: immunology
  • Biliary
  • Biliary: etiology
  • Chronic Disease
  • Female
  • Fluorescent Antibody Technique
  • Fluorescent Antibody Technique: methods
  • Humans
  • Liver Cirrhosis
  • Liver Diseases
  • Liver Diseases: complications
  • Liver Diseases: diagnosis
  • Liver Diseases: immunology
  • Male
  • Middle Aged
  • Prognosis

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Authors

  • a Granito

  • P Muratori

  • L Muratori

  • G Pappas

  • F Cassani

  • J Worthington

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