Review
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2005; 11(43): 6735-6739
Published online Nov 21, 2005. doi: 10.3748/wjg.v11.i43.6735
Enzyme inhibition assay for pyruvate dehydrogenase complex: Clinical utility for the diagnosis of primary biliary cirrhosis
Katsuhisa Omagari, Hiroaki Hazama, Shigeru Kohno
Katsuhisa Omagari, Hiroaki Hazama, Shigeru Kohno, Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Katsuhisa Omagari, MD, Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. omagari@net.nagasaki-u.ac.jp
Telephone: +81-95-849-7281 Fax: +81-95-849-7285
Received: April 25, 2005
Revised: June 1, 2005
Accepted: June 2, 2005
Published online: November 21, 2005
Abstract

Primary biliary cirrhosis (PBC) is usually diagnosed by the presence of characteristic histopathological features of the liver and/or antimitochondrial antibodies (AMA) in the serum traditionally detected by immunofluorescence. Recently, new and more accurate serological assays for the detection of AMA, such as enzyme-linked immunosorbent assay (ELISA), immunoblotting, and enzyme inhibition assay, have been developed. Of these, the enzyme inhibition assay for the detection of anti- pyruvate dehydrogenase complex (PDC) antibodies offers certain advantages such as objectivity, rapidity, simplicity, and low cost. Since this assay has almost 100% specificity, it may have particular applicability in screening the at-risk segment of the population in developing countries. Moreover, this assay could be also used for monitoring the disease course in PBC. Almost all sera of PBC-suspected patients can be confirmed for PBC or non-PBC by the combination results of immunoblotting and enzyme inhibition assay without histopathological examination. For the development of a “complete” or "gold standard" diagnostic assay for PBC, similar assays of the enzyme inhibition for anti-2-oxoglutarate dehydrogenase complex (OGDC) and anti-branched chain oxo-acid dehydrogenase complex (BCOADC) antibodies will be needed in future.

Keywords: Primary biliary cirrhosis, Enzyme inhibition assay, Antimitochondrial antibody, 2-oxo-acid dehydrogenase complex