title: Anti-nucleosome autoantibodies as markers for autoimmune hepatitis and their correlation with disease activity.
abstract: OBJECTIVE
  To assess the prevalence of autoantibodies against nucleosomes (anti-nucleosome Ab) in patients with autoimmune hepatitis (AIH), examine the correlation between anti-nucleosome Ab and disease activity, and evaluate the effectiveness of anti-nucleosome Ab in predicting relapse.
  
  
  METHODS
  We analyzed serum anti-nucleosome Ab levels in 38 patients with AIH by enzyme-linked immunosorbent assay, and assessed their correlation with clinical characteristics.
  
  
  RESULTS
  Anti-nucleosome Ab levels were significantly higher in AIH, but not in patients with chronic hepatitis B (n = 20) or chronic hepatitis C (n = 20), compared to healthy controls (n = 15). The positive prevalence of anti-nucleosome Ab was 71.1% in AIH. Anti-nucleosome Ab levels were significantly lower during remission compared to that during flares within the same patients with AIH. Total bilirubin levels were significantly higher in patients with anti-nucleosome Ab levels of 53.7 U/mL or more compared to those with less than 53.7 U/mL at disease onset. Analysis of the reduction in anti-nucleosome Ab by immunosuppressive therapy in 16 AIH patients revealed that age at disease onset was significantly lower and IgG levels and relapse rates were significantly higher in patients with a reduction rate of less than 35% compared to those with a reduction rate 35% or more. The International Autoimmune Hepatitis Group score and γ-globulin levels were also higher in patients with reduction rates of less than 35% (borderline significance).
  
  
  CONCLUSIONS
  Anti-nucleosome Ab in AIH patients may be useful markers not only for disease diagnosis, but also for activity assessment and relapse prediction.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Yokokawa
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanno
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Monoe
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Katsushima
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hirohide
authors.initials: H
authors.lastname: Yokokawa
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
keywords: anti-nucleosome antibody; autoimmune hepatitis; nucleosome; relapse