title: Clinicopathological significance of antinuclear antibodies in non-alcoholic steatohepatitis.
abstract: 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.
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Niwa
authors.forename: Motoko
authors.initials: M
authors.lastname: Sasaki
authors.forename: Joji
authors.initials: J
authors.lastname: Haratake
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kasai
authors.forename: Kazuyoshi
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authors.lastname: Katayanagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurumaya
authors.forename: Shinji
authors.initials: S
authors.lastname: Masuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Minato
authors.forename: You
authors.initials: Y
authors.lastname: Zen
authors.forename: Akio
authors.initials: A
authors.lastname: Uchiyama
authors.forename: Atsuo
authors.initials: A
authors.lastname: Miwa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Saito
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Sudo
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma