title: A contemporary perspective on the molecular characteristics of mitochondrial autoantigens and diagnosis in primary biliary cholangitis.
abstract: Primary biliary cholangitis (PBC) is an autoimmune hepatobiliary disease characterized by immune mediated destruction of the intrahepatic small bile ducts and the presence of antimitochondrial antibodies (AMAs). The mitochondrial autoantigens have been identified as the E2 subunits of the 2-oxo-acid dehydrogenase complex, including the E2 subunits of pyruvate dehydrogenase, branched-chain 2-oxo acid dehydrogenase complex, oxoglutarate dehydrogenase complex, E3 binding protein and PDC E1 alpha subunit. The AMA epitope is mapped within the E2 lipoic acid binding domain, which is particularly important for oxidative phosphorylation. In addition, lipoic acid, which serves as a swinging arm to capture electrons, is particularly susceptible to an electrophilic attack and may provide clues to the etiology of PBC. This review emphasizes the molecular characteristics of AMAs, including detection, immunochemistry and the putative role in disease. These data have significance not only specifically for PBC, but generically for autoimmunity.
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: Patrick S C
authors.initials: PS
authors.lastname: Leung
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: Jinjung
authors.initials: J
authors.lastname: Choi
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Yang
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Woo
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Kenny
authors.affiliation: a Division of Rheumatology, Allergy and Clinical Immunology , University of California at Davis School of Medicine , Davis , CA , USA.
authors.forename: M Eric
authors.initials: ME
authors.lastname: Gershwin
mesh_terms: D001324:Autoantigens / Q000097:blood / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002761:Cholangitis / Q000097:blood* / Q000209:etiology / Q000276:immunology; D006801:Humans; D024101:Mitochondrial Proteins / Q000276:immunology*; D025202:Molecular Diagnostic Techniques / Q000379:methods; D012698:Serologic Tests / Q000379:methods
chemical_list: D001324:Autoantigens; D015415:Biomarkers; D024101:Mitochondrial Proteins
keywords: Antimitochondrial antibodies; E2 subunit of pyruvate dehydrogenase (PDC-E2); ELISA; Luminex bead assay; enzyme inhibition assay; immunoblotting; indirect immunofluorescence