Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)

The aim of this study was to investigate the frequency and quality of immunological overlap in serum AMA M2 positives. During the period January 2004 - December 2006, out of 3000 sera evaluated, 40 were AMA M2 positive. Six of these (15%) were without immunological overlap; they had clinical, histol...

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Main Authors: Caterina Defendenti, Simona Bollani, Gabriella Munegato, Simone Saibeni, Maria Sofia, Savino Bruno, Mariella Saudelli, Maurizio Picca
Format: Article
Language:English
Published: PAGEPress Publications 2008-06-01
Series:Microbiologia Medica
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Online Access:http://www.pagepressjournals.org/index.php/mm/article/view/2580
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author Caterina Defendenti
Simona Bollani
Gabriella Munegato
Simone Saibeni
Maria Sofia
Savino Bruno
Mariella Saudelli
Maurizio Picca
author_facet Caterina Defendenti
Simona Bollani
Gabriella Munegato
Simone Saibeni
Maria Sofia
Savino Bruno
Mariella Saudelli
Maurizio Picca
author_sort Caterina Defendenti
collection DOAJ
description The aim of this study was to investigate the frequency and quality of immunological overlap in serum AMA M2 positives. During the period January 2004 - December 2006, out of 3000 sera evaluated, 40 were AMA M2 positive. Six of these (15%) were without immunological overlap; they had clinical, histological and biochemical features of classical PBC with a normal length of life and ursodeoxycholic acid responding. In other 16 patients (40%), there was an association with antibody against antigens as SLA/LP, gp210 and Sp100, that causes the overlap syndrome AIH/PBC with various level of seriousness.The association with anti SLA/LP or with high level of autoantibody anti-Sp100 (index ELISA>10) waspresent in the patients investigated, as AIH type I°. Patients positive for anti gp210 with low anti-Sp100 index had instead a weak overlap AIH/PBC with slow evolving aspects. Nobody was positive for anti-LKM1, anti-LC, PML, or LBR.The remaining 45% of sera were positive for ANA, ENA,ANCA, with different clinical features. The antibody anti-SSARo52 and anti-centromere were frequent (17%) and modified the liver disease evolution.The most serious clinical case was a double overlap anti-centromere/SSARo52 with biochemical and histological AIH symptoms. Other ENA patterns did worsen the prognosis of PBC but showed or were associated with systemic diseases, often after a long asymptomatic period.The ANA IFI positive with a speckled pattern ENA negative, in other 7 patients (17%) worsened the long term prognosis because they expressed an overlap AIH/PBC with slowly evolving aspects.The most serious and intense clinical picture, with transplant perspective, was the association of the AMA M2 with anti Sp100 (index > 10) and pANNA. Four case were male (10%) but females were prevalent.
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spelling doaj.art-355dbb5af19e4c9ea904c963c90bbd912022-12-22T01:47:55ZengPAGEPress PublicationsMicrobiologia Medica2280-64232008-06-0123210.4081/mm.2008.25801833Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)Caterina DefendentiSimona BollaniGabriella MunegatoSimone SaibeniMaria SofiaSavino BrunoMariella SaudelliMaurizio PiccaThe aim of this study was to investigate the frequency and quality of immunological overlap in serum AMA M2 positives. During the period January 2004 - December 2006, out of 3000 sera evaluated, 40 were AMA M2 positive. Six of these (15%) were without immunological overlap; they had clinical, histological and biochemical features of classical PBC with a normal length of life and ursodeoxycholic acid responding. In other 16 patients (40%), there was an association with antibody against antigens as SLA/LP, gp210 and Sp100, that causes the overlap syndrome AIH/PBC with various level of seriousness.The association with anti SLA/LP or with high level of autoantibody anti-Sp100 (index ELISA>10) waspresent in the patients investigated, as AIH type I°. Patients positive for anti gp210 with low anti-Sp100 index had instead a weak overlap AIH/PBC with slow evolving aspects. Nobody was positive for anti-LKM1, anti-LC, PML, or LBR.The remaining 45% of sera were positive for ANA, ENA,ANCA, with different clinical features. The antibody anti-SSARo52 and anti-centromere were frequent (17%) and modified the liver disease evolution.The most serious clinical case was a double overlap anti-centromere/SSARo52 with biochemical and histological AIH symptoms. Other ENA patterns did worsen the prognosis of PBC but showed or were associated with systemic diseases, often after a long asymptomatic period.The ANA IFI positive with a speckled pattern ENA negative, in other 7 patients (17%) worsened the long term prognosis because they expressed an overlap AIH/PBC with slowly evolving aspects.The most serious and intense clinical picture, with transplant perspective, was the association of the AMA M2 with anti Sp100 (index > 10) and pANNA. Four case were male (10%) but females were prevalent.http://www.pagepressjournals.org/index.php/mm/article/view/2580Overlap syndromes, Primary biliary cirrhosis, Serum autoantibodies,Autoimmunity
spellingShingle Caterina Defendenti
Simona Bollani
Gabriella Munegato
Simone Saibeni
Maria Sofia
Savino Bruno
Mariella Saudelli
Maurizio Picca
Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
Microbiologia Medica
Overlap syndromes, Primary biliary cirrhosis, Serum autoantibodies,Autoimmunity
title Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
title_full Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
title_fullStr Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
title_full_unstemmed Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
title_short Local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis (PBC)
title_sort local esperience on frequency and significance of immunological overlap in the field of primary biliary cirrhosis pbc
topic Overlap syndromes, Primary biliary cirrhosis, Serum autoantibodies,Autoimmunity
url http://www.pagepressjournals.org/index.php/mm/article/view/2580
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