Cited by 83Liver Diseases and ImmunityPediatric Hepatobiliary Diseases and TreatmentsLiver Disease and Transplantation

Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure?

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Yang, Wei-Hong, Yu, Jiang Hong, Nakajima, Ayako, Neuberg, Donna, Lindor, Keith, Bloch, Donald B.·2004·Clinical Gastroenterology and Hepatology

Abstract

Background & aims Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease with a variable clinical course. Identification of serologic markers associated with increased risk of liver failure would assist in management of PBC patients. The objective of this study was to identify antinuclear antibody (ANA) markers that may be used to predict PBC outcome. Methods Indirect immunofluorescence was used to identify ANAs in 492 PBC patients. chi2 and Kaplan-Meier analyses were used to examine the association between ANAs and liver failure. Results A greater percentage of ANA-positive, compared to ANA-negative, PBC patients developed liver failure (41% vs 25%, P = .005). The presence of anti-centromere antibodies was associated with liver failure (anti-centromere antibody positive vs negative, 58% vs 33%, P = .001). The time to liver failure was shorter in ANA-positive, compared with ANA-negative, patients (log rank score 5.8, P = .02). After 8.9 years (the median follow-up for patients without liver failure), 68% of ANA-positive and 81% of ANA-negative patients were free of liver failure. Anti-centromere antibodies were also associated with a shorter time to liver failure (log rank score 8.4, P = .004). After 8.9 years, 52% of anti-centromere antibody positive and 74% of anti-centromere antibody negative patients were without liver failure. Conclusions ANAs in general, and anti-centromere antibodies in particular, are associated with liver failure in PBC. PBC patients with ANAs may be candidates for treatment with experimental therapies to prolong the interval between diagnosis and liver failure. ANA-negative patients, who appear to have a relatively benign clinical course, should perhaps be treated with ursodeoxycholic acid alone.

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Crossref · 10.1016/s1542-3565(04)00465-3

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  • There is evidence to suggest that PBC-linked ANA (in particular anti-gp210/anti-nuclear rim antibody) may be associated with more rapidly progressive disease and disease which is less responsive to UDCA therapy.

    “There is evidence to suggest that PBC-linked ANA (in particular anti-gp210/anti-nuclear rim antibody) may be associated with more rapidly progressive disease and disease which is less responsive to UDCA therapy.76 79–82”

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Authors
Yang, W.-H., Yu, J. H., Nakajima, A., Neuberg, D., Lindor, K., & Bloch, D. B.
Affiliations
  • Harvard University (US)
  • Mayo Clinic (US)
Corresponding author
Bloch, Donald B.
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2004-12
Volume
2
Issue
12
Pages
1116-1122
ISSN
1542-3565 (ISSN-L)
OpenAlex
W2015610424
Cited by
83
References
32
Citations by year
2026: 3 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 7 · 2013: 5 · 2012: 10
FWCI
2.50
Type
journal article
Language
en
Open access
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (DK 40561, R29DK051179, DK051179, P30DK040561)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
  • Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
primary biliary cirrhosis, antinuclear antibodies, anti-centromere antibodies, liver failure, serological markers, prognosis, cholestatic liver disease, ursodeoxycholic acid
MeSH terms
Antibodies, Antinuclear, Centromere, Female, Follow-Up Studies, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Cohort Studies, Biomarkers, Liver Failure, Risk Assessment, Fluorescent Antibody Technique, Indirect

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