The clinical significance of anti-saccharomyces cerevisia antibody in primary biliary cirrhosis / 中华风湿病学杂志

ABSTRACT

Objective To explore the prevalence of the anti-saccharomyces cerevisiae antibody (ASCA) in patients with primary biliary cirrhosis and evaluate it's clinical significance. Methods The subtypes of ASCA including IgA and IgG in blood samples from 162 patients with PBC, 44 patients with AIH,4-1 patients with other non-autoimmune liver diseases controls (LDC), 144 patients with inflammatory bowel disease (IBD) and 35 healthy controls were measured by ELISA. Chi-square test and Mann Whitney U test were used for statistical analysis. Results The positive rate of ASCA-IgA in PBC was 24.1%, which was higher than that in ulcerative colitis (UC) group ( 11.6%,χ2=5.5, P＜0.05 ) and healthy controls (0, χ2=10.5,P＜0.01 ). Compared with the AIH group (20.5%) or LDC group ( 14.6% ) or Crohn's disease (CD) (34.5%),there was no statistically significant difference (P＞0.05). The prevalence of ASCA-IgG in PBC was 11.1%,lower than the CD group (27.6%, χ2=8.9, P＜0.01 ), but higher than that in the healthy controls (0, χ2=10.5,P＜0.01 ). There was no statistically significant difference (P＞0.05) between PBC and the AIH group (15.9%)or LDC group (7.3%) or UC group (8.1% ). The positive rate of both ASCA-IgA and ASCA-IgG in PBC was only 6.2%, statistically lower than that of the CD group ( 17.2%, χ2=6.3, P＜0.05). The prevalence of ASCA-IgA or ASCA-IgG in PBC was 29.0%, which was statistically lower than that of the CD group (44.8%, χ2=4.8,P＜0.05), but higher than that of the UC group (χ2=5.9, P＜0.05) or healthy controls (χ2=13.3, P＜0.01).ASCA was detected more frequently in PBC patients with positive anti-GP210 antibody than in anti-GP210 antibody negative PBC patients (38.6% vs 23.8%,χ2=3.9, P＜0.05). The positive rate of ASCA between AMA positive and negative patients with PBC or anti-SP100 antibodies positive and negative patients with PBC was not significantly different. PBC patients with positive ASCA-IgA had higher level of TBIL, DBIL, TBA, LD,IgA, IgM, ESR and lower level of ALB, A/G, CHE than patients with negative ASCA-IgA. There was no statistically significant difference in liver injury indicators and immune function parameters between patients with positive ASCA-IgG and negative ASCA-IgG. Conclusion ASCA is not an IBD-specific antibody. There is a high prevalence of ASCA in patients with PBC, especially the subtype of ASCA-IgA. ASCA-IgA is found to be associated with the severity of liver damage and immune activity whereas ASCA-IgG is not associated with them.