Frequency and significance of antibodies to asialoglycoprotein receptor in type 1 autoimmune hepatitis
Antibodies to asialoglycoprotein receptor have diagnostic specificity for autoimmune hepatitis, but it is uncertain if they are complementary or redundant markers of the disease. Our aims were to assess their frequency and significance in type 1 autoimmune hepatitis and determine their contribution to the evaluation of these patients. Sear from 54 well-characterized patients were evaluated for antibodies to asialoglycoprotein receptor by a radioimmunofiltration assay based on rabbit-derived protein. Forty-four patients (82%) were seropositive. Seropositive patients were distinguished from seronegative counterparts by having higher serum gamma globulin (3.7±0.2 g/dl vs 2.3±0.3 g/dl,P=0.0007) and immunoglobulin G levels (3707±179 mg/dl vs 2203±263 mg/dl,P=0.0005) at presentation and a greater frequency of relapse after drug withdrawal (88% vs 33%,P=0.01). Seropositivity for smooth muscle and/or antinuclear antibodies did not define treatment outcomes and antinuclear antibodies occurred less frequently than the other markers. Concurrent testing for antibodies to asialoglycoprotein receptor and smooth muscle identified all patients. We conclude that antibodies to asialoglycoprotein receptor are common in type 1 autoimmune hepatitis and they identify patients with a high frequency of relapse after corticosteroid withdrawal. Concurrent testing for these antibodies and smooth muscle antibodies has the same diagnostic sensitivity as testing for antinuclear and smooth muscle antibodies but a greater prognostic implication.
Key wordsasialoglycoprotein receptor autoantibodies autoimmune hepatitis
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- 3.Johnson PJ, McFarlane IG, Alvarez F, Bianchi FB, Bianchi L, Burroughs A, Chapman RW, Czaja AJ, Desmet V, Eddleston ALWF, Gerber MA, Hoofnagle JH, Kakumu S, MacSween RNM, Maddrey WC, Manns MP, Meyer zum Buschenfelde K-H, Mieli-Vergani G, Portmann BC, Reed WD, Schalm SW, Scheuer PJ, Toda G, Tsuji T, Tygstrup N, Vergani D, Zeniya M: Meeting report. International Autoimmune Hepatitis Group. Hepatology 18:998–1005, 1993PubMedGoogle Scholar
- 5.International Working Party: Terminology of chronic hepatitis. Am J Gastroenterol 90:181–189, 1995Google Scholar
- 6.Czaja AJ: Autoimmune chronic active hepatitis-a specific entity? The negative argument. J Gastro-Hepatol 5:343–351, 1990Google Scholar
- 9.Homberg J-C, Abuaf N, Bernard O, Islam S, Alvarez F, Khalil SH, Poupon R, Darnis F, Levy V-G, Grippon P, Opolon P, Bernuau J, Benhamou J-P, Alagille D: Chronic active hepatitis associated with antiliver/kidney microsome antibody type 1: A second type of “autoimmune” hepatitis. Hepatology 7:1333–1339, 1987PubMedGoogle Scholar
- 21.Czaja AJ, Ming C, Shirai M, Nishioka M: Frequency and significance of antibodies to histones in autoimmune hepatitis. J Hepatol 23:32–38, 1995Google Scholar
- 32.Lohr H, Treichel U, Poralla T, Manns M, Meyer zum Buschenfelde K-H, Fleischer B: Liver-infiltrating T helper cells stimulate the production of autoantibodies against the human asialoglycoprotein receptor in autoimmune chronic active hepatitis in vitro. Clin Exp Immunol 88:45–49, 1992PubMedGoogle Scholar
- 35.Czaja AJ: Autoimmune hepatitis: current therapeutic concepts. Clin Immunother 1:413–429, 1994Google Scholar