title: Elimination of circulatory IgM anti-HSA precedes anti-HBe seroconversion in patients with CAH type B.
abstract: The presence of IgM and IgA antibodies with specificity for human serum albumin (HSA) were consecutively analyzed in serum samples from four patients with biopsy verified CAH type B during seroconversion in the HBe/anti-HBe antigen system. Circulatory IgM anti-HSA antibodies were present during HBe antigenemia. The antibody titers fluctuated, decreased, and were finally lost from the circulation. After the disappearance of IgM anti-HSA antibodies, seroconversion to anti-HBe reactivity occurred and a quiescent phase of the disease was established, as judged by normalization of transaminases and absence of circulatory HBV-DNA. IgA anti-HSA antibodies persisted in the circulation after the elimination of IgM anti-HSA and seroconversion to anti-HBe reactivity. For one of the patients, a dramatic increase in titers was followed by elimination of IgA anti-HSA and seroconversion to anti-HBs. The data indicate that the host "self"-component HSA, when associated with "foreign" HBe or HBs antigenic structures, elicit immune responses to HSA, preventing the adequate development of anti-HBe and anti-HBs. The cessation of anti-HSA reactivity, however, seemed to permit subsequent sensitization to HBe and HBs antigenic determinants, as detected by the presence of circulatory antibodies.
authors.affiliation: Department of Infectious Diseases, Karolinska Institute, Roslagstull Hospital, Stockholm, Sweden.
authors.forename: U B
authors.initials: UB
authors.lastname: Hellström
authors.forename: S P
authors.initials: SP
authors.lastname: Sylvan
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000276:immunology*; D006509:Hepatitis B / Q000097:blood / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000276:immunology*; D006521:Hepatitis, Chronic / Q000097:blood / Q000276:immunology*; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests; D012709:Serum Albumin / Q000276:immunology*
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D007075:Immunoglobulin M; D012709:Serum Albumin