Clinicopathological significance of antinuclear antibodies in non-alcoholic steatohepatitis.
OBJECTIVE
Serum antinuclear antibodies (ANA) are occasionally noted in patients with non-alcoholic steatohepatitis (NASH). We examined the significance of ANA in NASH.


METHODS
We compared clinicopathological features in patients with ANA-positive NASH (n = 35) and ANA-negative NASH (n = 36). Inflammatory cell profiles and the distribution of oxidative stress markers were also examined immunohistochemically.


RESULTS
ANA-positive NASH was significantly associated with female gender (P = 0.005), high degree of portal inflammation (P = 0.039), interface activity (P = 0.036) and hepatocellular ballooning (P = 0.0008). In addition, ANA of high titer (320-fold or more) was significantly associated with the histological grade and stage of NASH (P = 0.02). The degree of steatosis wais rather mild in the high-titer ANA group(P = 0.01). The analysis of inflammatory cell profiles revealed that CD3-positive T cells were predominant and plasma cells were rather few in the portal area and hepatic lobules in both ANA-positive and ANA-negative groups. There was no difference in the distribution of oxidative stress markers between ANA-positive and ANA-negative groups.


CONCLUSIONS
These findings suggest that the presence of ANA may be related to the progression of NASH and that a different type of autoimmune mechanism may be involved in the pathogenesis of NASH with ANA, compared to the pathogenesis of autoimmune hepatitis.
Niwa
Hideki
H
Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Sasaki
Motoko
M
Haratake
Joji
J
Kasai
Takahiko
T
Katayanagi
Kazuyoshi
K
Kurumaya
Hiroshi
H
Masuda
Shinji
S
Minato
Hiroshi
H
Zen
You
Y
Uchiyama
Akio
A
Miwa
Atsuo
A
Saito
Katsuhiko
K
Sudo
Yoshiko
Y
Nakanuma
Yasuni
Y