Correlation of initial autoantibody profile and clinical outcome in primary biliary cirrhosis.
Although there have been significant advances in understanding the clinical and biochemical features of primary biliary cirrhosis (PBC), there is still a paucity of data on the usefulness of biomarkers as prognostic indicators. This is particularly important at the time of initial diagnosis. Indeed, the widespread use of antimitochondrial antibody testing has led to an earlier diagnosis of asymptomatic PBC and it is difficult to predict which patients will experience a benign versus a rapidly progressive course. To address this issue, we examined a unique population of 127 newly diagnosed patients with PBC during a 15-year period of observation that began in January 1990. Sera from these patients were analyzed for antimitochondrial, antinuclear, and anti-smooth muscle antibodies, and immunoblotting was performed for nuclear pore complex (NPC). The patients were then followed up longitudinally using biochemical liver function tests. No patient was under any medical therapy for PBC at the time of the initial sera collection. Data were analyzed based not only on the clinical features, but also the Mayo score and specific outcome measures, including time to death, need for liver transplantation, and complication free survival. Among patients with early disease, bilirubin increased to >2 mg/dL in the anti-NPC(+) patients (26% vs. 5%, P = .019). Anti-NPC antibodies remained stable or slightly increased over the period of observation. In condusion, anti-NPC identifies patients likely to experience an unfavorable clinical course and more rapid disease progression.
Wesierska-Gadek
Józefa
J
First Department of Internal Medicine, Institute of Cancer Research, Vienna Medical University, Vienna, Austria.
Penner
Edward
E
Battezzati
Pier Maria
PM
Selmi
Carlo
C
Zuin
Massimo
M
Hitchman
Eva
E
Worman
Howard J
HJ
Gershwin
M Eric
ME
Podda
Mauro
M
Invernizzi
Pietro
P
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood*; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000276:immunology; D022022:Nuclear Pore / Q000276:immunology; D011379:Prognosis; D011446:Prospective Studies
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D015415:Biomarkers