Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Autoantibody profiles in autoimmune hepatitis and chronic hepatitis C identifies similarities in patients with severe disease
Kawa Amin, Aram H Rasool, Ali Hattem, Taha AM Al-Karboly, Taher E Taher, Jonas Bystrom
Kawa Amin, Department of Medical Science, Respiratory Medicine and Allergology, Clinical Chemistry and Asthma Research Centre, Uppsala University and University Hospital, SE-751 85 Uppsala, Sweden
Kawa Amin, Department of Microbiology/Immunology, School of Medicine, University of Sulaimani, Sulaimani 334, Iraq
Aram H Rasool, Laboratory Department, General Hospital of Derbandixan, Derbandixan 332, Iraq
Ali Hattem, Department of Community Health, Sulaimani Polytechnic University, Sulaimani 334, Iraq
Taha AM Al-Karboly, Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani; Kurdistan Center for Gastroenterology and Hepatology, Sulaimani 334, Iraq
Taher E Taher, Jonas Bystrom, Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London, Queen Mary, University of London, Charterhouse Square, EC1M 6BQ London, United Kingdom
Author contributions: Amin K, Rasool AH, Hattem A, Al-Karboly TAM, Taher TE and Bystrom J designed the experiments for this study; Rasool AH, Hattem A and Al-Karboly TAM performed the experiments; Amin K, Rasool AH, Hattem A, Al-Karboly TAM, Taher TE and Bystrom J analysed the data and wrote the manuscript.
Supported by Bror Hjerpstedts Foundation, Sweden.
Institutional review board statement: Approval of the study was received from the Ethics board and the Office of the vice president for scientific affairs and postgraduate studies at the Sulimani University.
Conflict-of-interest statement: The authors declare no conflict to interest.
Data sharing statement: If they received a written request, for scientific purposes, the authors would be able to share the (anonymized) raw data used in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kawa Amin, PhD, Assistant Professor, Department of Microbiology/Immunology, School of Medicine, University of Sulaimani, Sulaimani 334, Iraq. kawa.amin@univsul.edu.iq
Telephone: +964-7701958515
Received: September 23, 2016
Peer-review started: September 26, 2016
First decision: October 28, 2016
Revised: November 17, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: February 28, 2017
AIM
To determine how the auto-antibodies (Abs) profiles overlap in chronic hepatitis C infection (CHC) and autoimmune hepatitis (AIH) and correlate to liver disease.
METHODS
Levels of antinuclear Ab, smooth muscle antibody (SMA) and liver/kidney microsomal-1 (LKM-1) Ab and markers of liver damage were determined in the sera of 50 patients with CHC infection, 20 AIH patients and 20 healthy controls using enzyme linked immunosorbent assay and other immune assays.
RESULTS
We found that AIH patients had more severe liver disease as determined by elevation of total IgG, alkaline phosphatase, total serum bilirubin and serum transaminases and significantly higher prevalence of the three non-organ-specific autoantibodies (auto-Abs) than CHC patients. Antinuclear Ab, SMA and LKM-1 Ab were also present in 36% of CHC patients and related to disease severity. CHC cases positive for auto-Abs were directly comparable to AIH in respect of most markers of liver damage and total IgG. These cases had longer disease duration compared with auto-Ab negative cases, but there was no difference in gender, age or viral load. KLM-1+ Ab CHC cases showed best overlap with AIH.
CONCLUSION
Auto-Ab levels in CHC may be important markers of disease severity and positive cases have a disease similar to AIH. Auto-Abs might have a pathogenic role as indicated by elevated markers of liver damage. Future studies will unravel any novel associations between these two diseases, whether genetic or other.
Core tip: This paper aims to determine what patients with chronic hepatitis C (CHC) and autoimmune hepatitis (AIH) produce autoantibodies. Disease duration in CHC is linked to disease severity and autoantibodies. Patients with severe CHC resemble AIH.
