Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 14, 2012; 18(34): 4721-4728
Published online Sep 14, 2012. doi: 10.3748/wjg.v18.i34.4721
Primary biliary cirrhosis-specific autoantibodies in first degree relatives of Greek primary biliary cirrhosis patients
Theodoros A Zografos, Nikolaos Gatselis, Kalliopi Zachou, Christos Liaskos, Stella Gabeta, George K Koukoulis, George N Dalekos
Theodoros A Zografos, Nikolaos Gatselis, Kalliopi Zachou, Christos Liaskos, Stella Gabeta, George N Dalekos, Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, 41110 Larissa, Greece
George K Koukoulis, Department of Pathology, Medical School, University of Thessaly, 41110 Larissa, Greece
Author contributions: Zografos TA, Zachou K and Dalekos GN had the original idea for the study, designed the study protocol and wrote the paper; Zografos TA, Gatselis N, Liaskos C and Gabeta S performed the whole immune serology work-up and along with Zachou K and Dalekos GN assessed the subjects from the immunological point of view; Koukoulis GK interpreted the histological data; Zografos TA, Zachou K and Gatselis N collected the data and performed the statistical analysis, and contributed to the final version of the paper; Koukoulis GK and Dalekos GN wrote the final version of the paper; and all authors approved the final draft of the paper.
Supported by The Research Committee of the University of Thessaly, No. 2466
Correspondence to: George N Dalekos, MD, PhD, Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Biopolis, 41110 Larissa, Greece. dalekos@med.uth.gr
Telephone: +30-241-3202285 Fax: +30-241-3501557
Received: February 3, 2012
Revised: March 31, 2012
Accepted: April 9, 2012
Published online: September 14, 2012
Abstract

AIM: To determine the prevalence and significance of primary biliary cirrhosis (PBC)-specific autoantibodies in first-degree relatives (FDRs) of Greek PBC patients.

METHODS: The presence of antimitochondrial antibodies (AMA) and PBC-specific antinuclear antibodies (ANA) were determined using indirect immunofluorescence assays, dot-blot assays, and molecularly based enzyme-linked immunosorbent assays in 101 asymptomatic for liver-related symptoms FDRs of 44 PBC patients. In order to specify our results, the same investigation was performed in 40 healthy controls and in a disease control group consisting of 40 asymptomatic for liver-related symptoms FDRs of patients with other autoimmune liver diseases namely, autoimmune hepatitis-1 or primary sclerosing cholangitis (AIH-1/PSC).

RESULTS: AMA positivity was observed in 19 (only 4 with abnormal liver function tests) FDRs of PBC patients and none of the healthy controls. The prevalence of AMA was significantly higher in FDRs of PBC patients than in AIH-1/PSC FDRs and healthy controls [18.8%, 95% confidence interval (CI): 12%-28.1% vs 2.5%, 95% CI: 0.1%-14.7%, P = 0.01; 18.8%, 95% CI: 12%-28.1% vs 0%, 95% CI: 0%-10.9%, P = 0.003, respectively]. PBC-specific ANA positivity was observed in only one FDR from a PSC patient. Multivariate analysis showed that having a proband with PBC independently associated with AMA positivity (odds ratio: 11.24, 95% CI: 1.27-25.34, P = 0.03) whereas among the investigated comorbidities and risk factors, a positive past history for urinary tract infections (UTI) was also independently associated with AMA detection in FDRs of PBC patients (odds ratio: 3.92, 95% CI: 1.25-12.35, P = 0.02).

CONCLUSION: In FDRs of Greek PBC patients, AMA prevalence is significantly increased and independently associated with past UTI. PBC-specific ANA were not detected in anyone of PBC FDRs.

Keywords: Primary biliary cirrhosis, Antimitochondrial antibodies, Anti-gp210, Anti-sp100, Liver autoimmunity