Abstract
Background
Anti-centromere antibody (ACA), a typical autoantibody of systemic sclerosis, is also detected in primary biliary cirrhosis (PBC). However, its pathogenic role is not fully understood. The aim of this study was to determine the association between ACA and kidney function in PBC.
Methods
A cohort of 37 patients diagnosed as having PBC from July 2001 to November 2011 at Yokosuka Kyosai Hospital was retrospectively analyzed for a follow-up period of 12 months. The annual rate of estimated glomerular filtration rate (eGFR) decline within 1 year after the diagnosis was evaluated. The factors associated with eGFR decline were evaluated by linear regression analysis and logistic regression analysis.
Results
Overall, 37 PBC patients were included, of whom 12 (32 %) had ACA. The patients with ACA had a lower eGFR (65.9 ± 19.9 vs. 80.3 ± 12.1 mL/min/1.73 m2, P = 0.01), a higher likelihood of chronic kidney disease (CKD) (58 vs. 4 %, P = 0.0005), and a higher rate of annual eGFR decline (−4.3 ± 5.1 vs. 0.2 ± 4.6 mL/min/year, P = 0.01) than those without ACA. Univariate regression analysis and multivariate regression analysis adjusted for potential cofounders including age, eGFR, sex, diabetes mellitus, and hypertension showed that ACA was associated with eGFR decline (P = 0.011 and 0.017, respectively). Multivariate logistic regression analysis adjusted for these cofounders showed that ACA was associated with eGFR decline less than −4 mL/min/year (odds ratio 7.21, 95 % confidence interval 0.93–56.1, P = 0.059).
Conclusions
ACA is an independent risk factor for CKD in PBC. Evaluation of ACA and kidney function is necessary to prevent CKD progression in PBC patients.
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References
Moroi Y, Peebles C, Fritzler MJ, Steigerwald J, Tan EM. Autoantibody to centromere (kinetochore) in scleroderma sera. Proc Natl Acad Sci USA. 1980;77:1627–31.
Zuber M, Gotzen R, Filler I. Clinical correlation of anticentromere antibodies. Clin Rheumatol. 1994;13:427–32.
Nakano M, Ohuchi Y, Hasegawa H, Kuroda T, Ito S, Gejyo F. Clinical significance of anticentromere antibodies in patients with systemic lupus erythematosus. J Rheumatol. 2000;27:1403–7.
Katano K, Kawano M, Koni I, Sugai S, Muro Y. Clinical and laboratory features of anticentromere antibody positive primary Sjogren’s syndrome. J Rheumatol. 2001;28:2238–44.
Nakamura M, Kondo H, Mori T, Komori A, Matsuyama M, Ito M, et al. Anti-gp210 and anti-centromere antibodies are different risk factors for the progression of primary biliary cirrhosis. Hepatology. 2007;45:118–27.
Invernizzi P, Selmi C, Ranftler C, Podda M, Wesierska-Gadek J. Antinuclear antibodies in primary biliary cirrhosis. Semin Liver Dis. 2005;25:298–310.
Parveen S, Morshed SA, Nishioka M. High prevalence of antibodies to recombinant CENP-B in primary biliary cirrhosis: nuclear immunofluorescence patterns and ELISA reactivities. J Gastroenterol Hepatol. 1995;10:438–45.
Gliddon AE, Doré CJ, Dunphy J, Betteridge Z, McHugh NJ, QUINS Trial Study Group. Antinuclear antibodies and clinical associations in a british cohort with limited cutaneous systemic sclerosis. J Rheumatol. 2011;38:702–5.
Nguyen B, Mayes MD, Arnett FC, del Junco D, Reveille JD, Gonzalez EB, et al. HLA-DRB1*0407 and *1304 are risk factors for scleroderma renal crisis. Arthritis Rheum. 2011;63:530–4.
Mandai S, Arai Y, Hirasawa S, Hirai T, Aki S, Inaba N, et al. Anti-centromere antibody-positive subjects presenting with hypertensive emergency and renal dysfunction in the absence of skin manifestations: a variant of systemic sclerosis or a novel entity? Intern Med. 2012;51:1567–72.
Hesselstrand R, Scheja A, Shen GQ, Wiik A, Akesson A. The association of antinuclear antibodies with organ involvement and survival in systemic sclerosis. Rheumatology. 2003;42:534–40.
Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ, American Association for Study of Liver Diseases. Primary biliary cirrhosis. Hepatology. 2009;50:291–308.
Scheuer P. Primary biliary cirrhosis. Proc R Soc Med. 1967;60:1257–60.
Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al., Japanese Society of Hypertension Committee. The Japanese society of hypertension guidelines for the management of hypertension (JSH 2009). Hypertens Res. 2009;32:3–107.
The Committee of Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. J Jpn Diabetes Soc. 2010;53:450–67.
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.
Shoji I, Takagi T, Kasukawa R. Anti-centromere antibody and CREST syndrome in patients with primary biliary cirrhosis. Intern Med. 1992;31:1348–55.
Hernandez NM, Casselbrant A, Joshi M, Johansson BR, Sumitran-Holgersson S. Antibodies to kidney endothelial cells contribute to a “leaky” glomerular barrier in patients with chronic kidney diseases. Am J Physiol Renal Physiol. 2012;302:884–94.
Servettaz A, Tamby MC, Guilpain P, Reinbolt J, de la Garcia Penã-Lefebvre P, Allanore Y, et al. Anti-endothelial cell antibodies from patients with limited cutaneous systemic sclerosis bind to centromeric protein B (CENP-B). Clin Immunol. 2006;120:212–9.
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Mandai, S., Kanda, E., Arai, Y. et al. Anti-centromere antibody is an independent risk factor for chronic kidney disease in patients with primary biliary cirrhosis. Clin Exp Nephrol 17, 405–410 (2013). https://doi.org/10.1007/s10157-012-0724-1
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DOI: https://doi.org/10.1007/s10157-012-0724-1