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- Title
Detection of IgA, IgM, and IgG subclasses of anti-M2 antibody by immunoblotting in autoimmune cholangitis: is autoimmune cholangitis an early stage of primary biliary cirrhosis?
- Authors
Nakajima, Mikako; Shimizu, Hidetake; Miyazaki, Akihisa; Watanabe, Sumio; Kitami, Noriyuki; Sato, Nobuhiro; Nakajima, M; Shimizu, H; Miyazaki, A; Watanabe, S; Kitami, N; Sato, N
- Abstract
Autoimmune cholangitis (AIC) has been proposed as a distinct disease entity from primary biliary cirrhosis (PBC), without antimitochondrial antibody (AMA) and anti-M2 antibody but with a high titer of antinuclear antibody (ANA) in the serum. However, negativity for AMA and anti-M2 antibody was determined by different methods in different studies. We hypothesized that anti-M2 antibody negativity in AIC resulted from methodological differences, including selection of the immunoglobulin subclass of the autoantibody. Twenty-three patients compatible with AIC whose serum tested negative for AMA and positive for ANA (> or = 1:80) were compared with 71 AMA-positive PBC patients. Laboratory findings, histology, and the pattern of anti-M2 antibody assessed by immunoblotting were compared. Alkaline phosphatase, total bilirubin, total cholesterol, and IgM values were lower in patients with AIC (P < 0.05, 0.01, respectively). Anti-smooth muscle antibody was detected more frequently in patients with AIC (P < 0.01). However, anti-M2 antibody was detected using immunoblotting not only in PBC but also in AIC cases. IgA class alone, IgM class alone, or both IgA and IgM classes of anti-M2 antibody were detected in 13%, 17%, and 22% of AIC patients, respectively, whereas they were not detected in PBC patients (P < 0.05, P < 0.01, P < 0.01). IgG class anti-M2 was detected in all patients with PBC, whereas it was detected in 48% of patients with AIC (P < 0.01). Histological evaluation showed that the early stages of disease were found more frequently in AIC (78%) than in PBC patients (39%) (P < 0.01). Anti-M2 antibody was detected by immunoblotting in all AIC patients. Hence, AIC is not a distinct disease from PBC. For diagnosing AIC and/or PBC, anti-M2 antibody should be examined by the immunoblotting assay to detect not only IgG but also IgA and IgM subclasses.
- Subjects
AUTOIMMUNE diseases; BILIARY tract; ANTINUCLEAR factors; ANTIGENS; AUTOANTIBODIES; IMMUNOBLOTTING; IMMUNOGLOBULINS; CIRRHOSIS of the liver; MITOCHONDRIA; NONPARAMETRIC statistics; CHOLANGITIS
- Publication
Journal of Gastroenterology, 1999, Vol 34, Issue 5, p607
- ISSN
0944-1174
- Publication type
journal article
- DOI
10.1007/s005350050380