In a subgroup of children with
chronic active hepatitis, circulating
autoantibodies occur that bind to liver and kidney endoplasmic reticulum (
anti-liver/kidney microsome antibody type I or anti-LKM1). Anti-LKM1 titers follow the severity of the disease and the presence of these
antibodies serves as a diagnostic marker for this
autoimmune hepatitis type II. We demonstrate that anti-LKM1 IgGs specifically inhibit the hydroxylation of
bufuralol in human liver microsomes. Using two assay systems with different selectivity for the two
cytochrome P-450 isozymes catalyzing
bufuralol metabolism in human liver, we show that anti-LKM1 exclusively recognizes
cytochrome P-450db1. Immunopurification of the LKM1
antigen from solubilized human liver microsomes resulted in an electrophoretically homogenous
protein that had the same molecular mass (50 kDa) as purified P-450db1 and an identical N-terminal amino acid sequence. Recognition of both purified P-450db1 and the immunoisolated
protein on western blots by several
monoclonal antibodies confirmed the identity of the LKM1
antigen with
cytochrome P-450db1.
Cytochrome P-450db1 has been identified as the target of a common genetic polymorphism of
drug oxidation. However, the relationship between the polymorphic
cytochrome P-450db1 and the appearance of anti-LKM1
autoantibodies as well as their role in the pathogenesis of
chronic active hepatitis remains speculative.