title: Clinical significance of autoantibodies to p53 protein in patients with autoimmune liver diseases.
abstract: BACKGROUND
  Autoantibodies to p53 (anti-p53) are rarely present in the sera of patients with autoimmune diseases or the sera of patients with malignancies.
  
  
  OBJECTIVE
  To examine the prevalence of anti-p53 in patients with autoimmune liver disease including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), AIH⁄PBC overlap syndrome (AIH⁄PBC OS) and primary sclerosing cholangitis (PSC), and to determine the clinical significance of anti-p53 in autoimmune liver diseases.
  
  
  METHODS
  Forty patients with AIH, 41 patients with PBC, eight patients with AIH⁄PBC OS and five patients with PSC were enrolled. Anti-p53 and antibodies to double-stranded DNA (anti-ds-DNA) were analyzed using commercially available ELISA kits. Demographic, laboratory and histological data were compared between the AIH groups seropositive and seronegative for anti-p53.
  
  
  RESULTS
  Six of 40 (15.0%) patients with AIH and four of eight (50.0%) patients with AIH⁄PBC OS were positive for anti-p53. One of 41 (2.4%) patients with PBC was also positive for anti-p53, but all five patients with PSC were negative, indicating a significantly higher prevalence of anti-p53 in patients with AIH or AIH⁄PBC OS compared with patients with PBC. None of the AIH patients positive for anti-p53 progressed to hepatic failure or relapsed after immunosuppressive treatment. Titres of anti-ds-DNA in patients with AIH and AIH⁄PBC OS significantly correlated with titres of anti-p53 (r=0.511; P=0.0213).
  
  
  CONCLUSIONS
  The emergence of anti-p53 is likely to be useful for discriminating AIH or AIH⁄PBC OS from PBC and helpful for predicting favourable prognoses in patients with AIH. DNA damage may trigger the production of anti-p53 in patients with AIH or AIH⁄PBC OS.
authors.affiliation: Department of Integrated Medicine, Kagawa University School of Medicine, Kagawa, Japan. thimoto@med.kagawa-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Himoto
authors.forename: Hirohito
authors.initials: H
authors.lastname: Yoneyama
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kurokohchi
authors.forename: Michio
authors.initials: M
authors.lastname: Inukai
authors.forename: Hisashi
authors.initials: H
authors.lastname: Masugata
authors.forename: Fuminori
authors.initials: F
authors.lastname: Goda
authors.forename: Reiji
authors.initials: R
authors.lastname: Haba
authors.forename: Seishiro
authors.initials: S
authors.lastname: Watanabe
authors.forename: Shoichi
authors.initials: S
authors.lastname: Senda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000276:immunology* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D020169:Caspases / Q000378:metabolism; D016009:Chi-Square Distribution; D015209:Cholangitis, Sclerosing / Q000276:immunology* / Q000378:metabolism; D004247:DNA / Q000276:immunology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000378:metabolism; D008105:Liver Cirrhosis, Biliary / Q000276:immunology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018709:Statistics, Nonparametric; D016159:Tumor Suppressor Protein p53 / Q000276:immunology* / Q000378:metabolism
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D015415:Biomarkers; D016159:Tumor Suppressor Protein p53; D004247:DNA; D020169:Caspases