XR precipitating antibodies in chronic liver disease: Clinical relevance and antigenic...
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XR PRECIPITATING ANTIBODIES IN CHRONIC LIVER DISEASE: CLINICAL RELEVANCE AND ANTIGENIC CHARACTERIZATION. F. Cassani, M. Fusconi, L. Selleri, L. Baffoni, M. Lenzi, U. Volta, F.B. Bianchi, E. Pisi. Istituto di Clinica Medica II, University of Bologna, Italy. Antibodies to extractable nuclear antigens from rabbit thymus (RTE) are frequently detec- ted by counterimmunoelectrophoresis (CIE) in sera from patients with connective tissue disea- se (CTD). A new system, termed XR, has been recently reported in association with chronic liver disease (CLD). We tested by CIE sera from 240 patients with various CLD (defined accor- ding to internationally accepted criteria) and 124 with CTD. Autoimmune CLD(52) PBC(83) HBV CLD(38) Cryptogenic+Alcoholic CLD(67) CTD(124) XR + 15(29%) 13(16%) 3(8%) 0 2(2%) XR proved to be different from CTD associated systems Sm, nRNP, SS-B(La), rRNP, Sci-70, Ma, PCNA, SL, PM-Scl, Jo-l. XR occurred only in sera positive for smooth muscle antibodies (SMA, detected by indirect immunofluorescence-IFL-on rat kidney sections) while it did not correlate with IFL antinuclear antibodies. Of the different SMA patterns (SMA T-G: positivity of vessels and periTubular and Glomerular structures, with anti actin specificity; SMA V: po- sitivity of Vessels only) SMA T-G was the commonest in XR positive (18/31) and SMA V (56/58~ in XR negative sera (p< 0.0001, chi square Yates'). Absorption of 3 XR and SMA T-G positive sera with RTE and purified G actin (from rabbit skeletal muscle) abolished both SMA T-G IFL staining and XR CIE positivity. XR is a marker of autoimmunity specific for CLD and rarely found in CTD, where different systems frequently occur. The close association with SMA, in particular SMA T-G, and the ab- sorption results point to actin as the target antigen of XR antibodies. CHRONIC ACTIVE HEPATITIS IS RESPONSIBLE OF HBV RELATED LIVER FIBROSIS IN ALCOHOLIC AND NON ALCOHOLIC PATIENTS P. CHOSSEGROS, P. CHEVALLIER, P. ADELENE, M. SEPETJAN, R. BRETT~, C. TREPO, Lab. d'Hygi~ne, Facult~ de M&decine Rockefeller 69008 LYON, Lab. d'Informatique 162, Avenue Lacassagne 69008 LYON, Unit& d'H&patologie H6p. des Charpennes 69603 VILLEURBANNE (France) A high prevalence of HBV serologic markers in alcoholics is a well established fact but the role of HBV in the progression of their liver diseases remains controvertial. We have studied 861 consecutive patients with chronic liver diseases hospitalized for a liver biopsy. All were tested for HBV serological markers (HBs and HBe Ags, anti HBs, anti HBe and anti HBc by RIA, Abbott) and HBc Ag in their liver (direct IF). The distinction between alcoholics (A, 408 ca- ses) and non alcoholics (NA, 453 cases) was made on a chronic daily consumption of 80 g of alcohol. i. The differences observed in NA for sex (p,O,O001), age (p<O,O005) and fibrosis (p (~ 0,005) according to HBV markers was not significant in A, 2. HBV serologic markers were significantly more frequent in NA (57 %) than in A (39 %, p ~0,0001), 3. The logistic progression equations using HBc Ag as the variable to explain (NA : logit HBc Ag = - 2,52 + 3,33 (Ag HBs +) + 1,58 {anti HBs and/or anti HBc) + 0,70 (agressivity) ; A : logit HBc Ag = - 3,26 + 3,91 (Ag HBs) + 1,79 (anti HBs and/or anti HBc) + 0,76 (agressivi- ty) show that if hepatic HBc Ag is less frequent in A, the significant relationship between its presence and liver agressivity is the same (p<O,O001) in the two groups whatever HBV serology, 4. C.A.H. was associated to a more important fibrosis in A as well as NA, suggesting an additional role of HBV and alcohol (p~O,Ol). In conclusion, HBV related fibrosis appears secondary to CAH in both A as well as NA. The discrepancies observed between former studies may be related to the exclusion of A with CAH. The above results suggest that A are infected later than non alcoholics. $111
Transcript of XR precipitating antibodies in chronic liver disease: Clinical relevance and antigenic...
XR PRECIPITATING ANTIBODIES IN CHRONIC LIVER DISEASE: CLINICAL RELEVANCE AND
ANTIGENIC CHARACTERIZATION.
F. Cassani, M. Fusconi, L. Selleri, L. Baffoni, M. Lenzi, U. Volta, F.B. Bianchi,
E. Pisi.
Istituto di Clinica Medica II, University of Bologna, Italy.
Antibodies to extractable nuclear antigens from rabbit thymus (RTE) are frequently detec-
ted by counterimmunoelectrophoresis (CIE) in sera from patients with connective tissue disea-
se (CTD). A new system, termed XR, has been recently reported in association with chronic
liver disease (CLD). We tested by CIE sera from 240 patients with various CLD (defined accor-
ding to internationally accepted criteria) and 124 with CTD.
Autoimmune CLD(52) PBC(83) HBV CLD(38) Cryptogenic+Alcoholic CLD(67) CTD(124)
XR + 15(29%) 13(16%) 3(8%) 0 2(2%)
XR proved to be d i f fe rent from CTD associated systems Sm, nRNP, SS-B(La), rRNP, Sci-70,
Ma, PCNA, SL, PM-Scl, Jo- l . XR occurred only in sera posit ive fo r smooth muscle antibodies
(SMA, detected by indi rect immunofluorescence-IFL-on ra t kidney sections) while i t did not
correlate with IFL antinuclear antibodies. Of the d i f fe ren t SMA patterns (SMA T-G: pos i t i v i t y
of vessels and periTubular and Glomerular structures, with anti act in spec i f i c i t y ; SMA V: po- s i t i v i t y of Vessels only) SMA T-G was the commonest in XR posit ive (18/31) and SMA V (56/58~
in XR negative sera (p< 0.0001, chi square Yates'). Absorption of 3 XR and SMA T-G posit ive sera with RTE and pur i f ied G actin (from rabbit skeletal muscle) abolished both SMA T-G IFL staining and XR CIE pos i t i v i t y .
XR is a marker of autoimmunity specif ic for CLD and rarely found in CTD, where d i f fe rent
systems frequently occur. The close association with SMA, in part icular SMA T-G, and the ab- sorption results point to actin as the target antigen of XR antibodies.
CHRONIC ACTIVE HEPATITIS IS RESPONSIBLE OF HBV RELATED LIVER FIBROSIS IN ALCOHOLIC AND NON ALCOHOLIC PATIENTS
P. CHOSSEGROS, P. CHEVALLIER, P. ADELENE, M. SEPETJAN, R. BRETT~, C. TREPO,
Lab. d'Hygi~ne, Facult~ de M&decine Rockefeller 69008 LYON, Lab. d'Informatique 162, Avenue Lacassagne 69008 LYON, Unit& d'H&patologie H6p. des Charpennes 69603 VILLEURBANNE (France)
A high prevalence of HBV serologic markers in alcoholics is a well established fact but the role of HBV in the progression of their liver diseases remains controvertial. We have studied 861 consecutive patients with chronic liver diseases hospitalized for a liver biopsy. All were tested for HBV serological markers (HBs and HBe Ags, anti HBs, anti HBe and anti HBc by RIA, Abbott) and HBc Ag in their liver (direct IF). The distinction between alcoholics (A, 408 ca- ses) and non alcoholics (NA, 453 cases) was made on a chronic daily consumption of 80 g of alcohol. i. The differences observed in NA for sex (p,O,O001), age (p<O,O005) and fibrosis (p (~ 0,005) according to HBV markers was not significant in A, 2. HBV serologic markers were significantly more frequent in NA (57 %) than in A (39 %, p ~0,0001), 3. The logistic progression equations using HBc Ag as the variable to explain (NA : logit HBc Ag = - 2,52 + 3,33 (Ag HBs +) + 1,58 {anti HBs and/or anti HBc) + 0,70 (agressivity) ; A : logit HBc Ag = - 3,26 + 3,91 (Ag HBs) + 1,79 (anti HBs and/or anti HBc) + 0,76 (agressivi- ty) show that if hepatic HBc Ag is less frequent in A, the significant relationship between its presence and liver agressivity is the same (p<O,O001) in the two groups whatever HBV serology, 4. C.A.H. was associated to a more important fibrosis in A as well as NA, suggesting an additional role of HBV and alcohol (p~O,Ol). In conclusion, HBV related fibrosis appears secondary to CAH in both A as well as NA. The discrepancies observed between former studies may be related to the exclusion of A with CAH. The above results suggest that A are infected later than non alcoholics.
$111
