Frequency and significance of antibodies to cyclic citrullinated peptide in type 1 autoimmune hepatitis.

Abstract

OBJECTIVES:

Determine the frequency, clinical phenotype, and prognostic implications of antibodies against cyclic citrullinated peptides in patients with type 1 autoimmune hepatitis.

METHODS:

Three hundred and ninety-five serum samples from 179 patients were tested by enzyme-linked immunosorbent assay, and findings correlated with clinical and histological features, frequency of HLA DR3 and DR4, and treatment outcome.

RESULTS:

Twenty patients (11%) had antibodies against cyclic citrullinated peptides. Seropositivity was associated with a higher frequency of rheumatoid arthritis (RA) (25 vs. 0%, P < 0.001). Patients with antibodies against cyclic citrullinated peptides also had a significantly greater occurrence of histological cirrhosis at presentation (47 vs. 20%, P = 0.01) and death from hepatic failure than seronegative patients (25 vs. 9%, P = 0.04). Cirrhosis at presentation occurred more commonly in the patients with antibodies against cyclic citrullinated peptides and RA than in the other patients (100 vs. 21%, P = 0.005).

CONCLUSIONS:

Antibodies against cyclic citrullinated peptides occur in a subgroup of patients with type 1 autoimmune hepatitis who have a greater occurrence of cirrhosis at presentation and death from hepatic failure. Their presence with RA at accession characterizes a subgroup with cirrhosis.

• Authors: Aldo Montano-Loza, Albert J Czaja, Herschel A Carpenter, Andrea Piette, Daniel Murphy, Zakera Shums, Rufus Burlingame, Gary L Norman
• Journal: Autoimmunity (Autoimmunity) Vol. 39 Issue 4 Pg. 341-8 (Jun 2006) ISSN: 0891-6934 [Print] England
• PMID: 16891223 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• HLA-DR3 Antigen
• HLA-DR4 Antigen
• Immunosuppressive Agents
• Peptides, Cyclic
• cyclic citrullinated peptide
• Aspartate Aminotransferases
• Azathioprine
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Arthritis, Rheumatoid (drug therapy, immunology)
• Aspartate Aminotransferases (blood)
• Autoantibodies (blood, immunology)
• Azathioprine (therapeutic use)
• Enzyme-Linked Immunosorbent Assay
• Female
• HLA-DR3 Antigen (blood)
• HLA-DR4 Antigen (blood)
• Hepatitis, Autoimmune (drug therapy, immunology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Liver Cirrhosis (immunology, pathology)
• Male
• Middle Aged
• Peptides, Cyclic (immunology)
• Prednisone (therapeutic use)
• Retrospective Studies