Certain
autoantibodies in autoimmune
liver disease have prognostic implications that are under-utilized and under-developed. The goals of this review are to indicate progress in characterizing the
autoantibodies with prognostic connotations and to indicate the feasibility and importance of discovering other markers. Prime source and review articles in English were selected by a Medline search through 2010.
Antibodies to
soluble liver antigen, actin, liver cytosol type 1,
asialoglycoprotein receptor,
chromatin,
cyclic citrullinated peptide, and
uridine glucuronosyltransferases have been associated with the occurrence, severity, and progression of
autoimmune hepatitis, and
antibodies to Sp100, gp210, and centromere have had similar implications in
primary biliary cirrhosis.
Antibodies to
soluble liver antigen have shown the most promise in
autoimmune hepatitis as they have been associated with severe histological changes, long durations of treatment, relapse after
drug withdrawal, and high frequency of
liver failure.
Antibodies to the nuclear rim
pore protein, gp210, have shown the most promise in
primary biliary cirrhosis as they have been associated with severe interface
hepatitis, lobular
inflammation, and progression to
liver failure. The major limitations of the
autoantibodies have been their lack of standardized assays, low negative predictabilities, and fluctuating levels. Performance parameters will improve as critical pathogenic pathways, comprehensive testing batteries, and standardized assays through international exchange workshops are developed. Progress has been made in identifying the serological markers of prognosis in autoimmune
liver disease, and they promise to reflect critical disease mechanisms and enhance patient management.