Is autoimmune cholangitis-anti-mitochondrial antibody-negative primary biliary cholangitis still an independent disease? / 中华肝脏病杂志

Autoimmune cholangitis (AIC) was first reported in 1987 as a chronic cholestatic disease that occurs predominantly in middle-aged women and has a common clinical manifestations, biochemical abnormalities and pathological changes with primary biliary cholangitis (PBC). However, serum anti-mitochondrial antibodies (AMA) are negative, and ANA and/or smooth muscle antibody positive rates are higher. The treatment response and prognosis with ursodeoxycholic acid and steroids is poor, thus it needs to be treated with immunosuppressive agents. Presently, the exact pathological mechanism of AIC is still unclear, and there is no unified assertion that classifies it as a new autoimmune liver disease or AMA-negative PBC. This article reviews the worldwide published work on AIC and compares them with PBC.

The comparison of different immunoassays for the detection on autoantibodies specific to primary biliary cholangitis / 中华检验医学杂志

Objective To compare the test performance of different immunoassays for the detection on autoantibodies specific to primary biliary cholangitis,including anti-mitochondrial type 2 antibody(AMA-M2),anti-glycoprotein 210(anti-gp210)and anti-nuclear body protein sp100(anti-sp100).Methods Serum samples from Primary Biliary Cholangitis(PBC, n=91), liver disease control(including viral hepatitis,autoimmune hepatitis and liver cirrhosis,n=67)and healthy individual(n=40)were collected from Beijing Youan Hospital during the period between April 2014 and April 2017.All samples were tested with chemiluminescent immunoassay(CLIA)and enzyme linked immunosorbent assay(ELISA)for AMA-M2, meanwhile the detection on anti-gp210 and anti-sp100 were compared between CLIA and Line Immunoassay(LIA).The Kappa coefficient were used to measure the level of qualitative agreement between different assays.The diagnostic accuracy of AMA-M2 detected with CLIA and ELISA were compared by receiver operating characteristic curve(ROC).Results The overall qualitative agreement between CLIA and ELISA for the detection to AMA-M2 is 88.4%(Kappa =0.765, P<0.01).Excellent qualitative agreement between CLIA and LIA for the detection to anti-gp210 and anti-sp100 was also found with overall agreement as 96.5%(Kappa=0.852,P<0.01)and 98%(Kappa=0.884,P<0.01), respectively.The ROC analysis also showed similar area under the curve(AUC)for CLIA(0.965, P<0.01)and ELISA (0.928,P<0.01)on detection to AMA-M2.Conclusions CLIA and ELISA showed excellent agreement for the detection to AMA-M2.High qualitative agreement between CLIA and LIA was also found when testing anti-gp210 and anti-sp100.

A Comparative Evaluation of the Performances of Anti-MIT3, Anti-gp210, and Anti-sp100 Antibodies for the Diagnosis of Primary Biliary Cirrhosis

BACKGROUND: Anti-mitochondrial antibody (AMA) is a serological hallmark of primary biliary cirrhosis (PBC). AMAs are detected by an immunofluorescence assay (IF), which is subject to errors. We evaluated the diagnostic performances of the AMA ELISA test (the anti-MIT3 antibody) and PBC-associated antinuclear antibody (ANA) tests (the anti-gp210 and anti-sp100 antibodies). METHODS: AMA, anti-gp210, and anti-sp100 were measured in the sera of 130 subjects including patients for whom the AMA test was requested with the clinical suspicion of PBC, patients with other autoimmune diseases, and those undergoing health check-ups. AMA was detected by both IF and ELISA (anti-MIT3 antibodies), and anti-gp210 and anti-sp100 were detected by ELISA. The diagnostic performances of the anti-MIT3, anti-gp210, and anti-sp100 were compared with that of the AMA IF test. Associations between the presence of anti-sp100 or anti-gp210 and the diagnosis and biochemical abnormalities of PBC were investigated. RESULTS: The area under the curve of anti-MIT3 for the diagnosis of PBC was 0.934 (95% confidence interval, 0.877-0.970), and the agreement between anti-MIT3 and AMA IF was 93.8% (kappa, 0.82). The sensitivities of anti-MIT3 and AMA IF were both 100%, and the specificities were 83.1% and 81.4%, respectively, whereas the sensitivities of anti-gp210 and anti-sp100 were 41.7% and 16.7%, and their specificities were 94.9% and 97.5%, respectively. The presence of anti-gp210 was associated with the diagnosis of PBC (P=0.0001), but that of anti-sp100 was not. CONCLUSIONS: The diagnostic performance of anti-MIT3 is comparable to that of AMA IF. Anti-gp210 seems to be complementary to AMA for the diagnosis of PBC.

Significance of serum anti-gp210 antibody detection in diagnosis of primary biliary cirrhosis / 临床肝胆病杂志

Primary biliary cirrhosis (PBC)is a chronic disease characterized by progressive destruction of intrahepatic small bile ducts, which may progress to liver cirrhosis.Anti-mitochondrial antibodies,especially anti-M2 antibody,have a high diagnostic value for PBC, but they are unrelated to the severity and prognosis of the disease and are negative in some patients.There have been reports from around the world that anti-nuclear antibodies,especially anti-gp210 antibody,are closely associated with PBC.It showed that anti-gp210 antibody has high specificity and sensitivity for the diagnosis of PBC,especially for the patients with negative anti-M2 antibody tests;in addition,it has a high predictive value for the prognosis and development model of the disease.Anti -gp210 antibody has a high diagnostic value for PBC,with great clinical significance,so its detection holds promise for clinical application.

Study of the relations between primary biliary cirrhosis and anti-gp210 and anti-sp100 antibody / 中华风湿病学杂志

Objective To evaluate the value of serologic teats in patients with primary biliary cirrhosis by conducting a seroprevalence survey for anti-gp210 and anti-sp100 antibodies.Methods A total of 72 consecutive primary biliary cirrhosis (PBC) patients with or without Sj(o)gren's syndrome (SS) and 50 patho logic controls were studied.Antibodies were tested by ELISA assays with recombinant spl00 and purified gp210.Results The positive rates of anti-gp210 detected by ELISA was 31.1% and 45.5% in PBC patients with and without SS respectively.Among SS and virus hepatitis patients,none had anti-gp210 antibody (P＜0.01).The prevalence of anti-gp210 was similar in PBC patients with and without SS.The positive rates of an ti-sp100 detected by ELISA was 14.8% and 18.2% in PBC patients with and without SS respectively.Among the patients with SS,only 3.3% was positive for anti-sp100,but none had anti-sp100 reactivity in virus hep atitis patients.The prevalence of anti-sp100 was not significantly different between PBC and SS groups. Conclusion Anti-gp210 and anti-sp100 are highly specific for PBC.The sensitivity of anti-gp210 and anti sp100 is 31.1% and 14.8% respectively.They may be helpful in the diagnosis of PBC.

The comparison of two different detection methods for anti-gp210 antibody / 中华风湿病学杂志

Objective To attempt using the synthetic poly-peptides in the carboxyl terminal of gp210 antigen as the substrate for anti-gp210 antibody detection and search for a simple assay method of detecting anti-gp210 antibody. Methods The enzyme linked immunosorbent assay (ELISA) method for anti-gp210 antibody detection was set-up by chessboard test. Anti-gp210 antibody was tested in the serum of both patients with primary biliary cirrhosis (PBC) and the control group by ELISA and immuno-blotting. Results The working concentration of gp210's antigen was 5 μg/ml. The optical density higher than 0.61 (x+3s) was designated as the positive cutoff of anti-gp210 antibody. There was no statistical difference between the two assays (P=0.617). And there was very strongly positive correlation between them (P=0.000, r=0.868). Conclusion The sensitivity and specificity are basically consistent between the assays using synthetic poly-peptides of gp210 antigen and native antigen as the detecting substrates. The former substrate is preferred to be used for the testing of anti-gp210 antibody in clinical laboratories.