Anti-gp210 & anti-centromere antibodies for the progression of PBC

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Hepatology. 2007 Jan;45(1):118-27.

Anti-gp210

and anti-centromere antibodies are different risk

factors for the progression of primary biliary cirrhosis.

Nakamura M, Kondo H, Mori T, Komori A, Matsuyama M, Ito M, Takii Y, Koyabu M, Yokoyama T, Migita K, Daikoku M, Abiru S, Yatsuhashi H, Takezaki E, Masaki N, Sugi K, Honda K, Adachi H, Nishi H, Watanabe Y, Nakamura Y, Shimada M, Komatsu T, Saito A, Saoshiro T, Harada H, Sodeyama T, Hayashi S, Masumoto A, Sando T, Yamamoto T, Sakai H, Kobayashi M, Muro T, Koga M, Shums Z, Norman GL, Ishibashi H.

Clinical Research Center, Omura, Nagasaki, Japan.

The predictive role of antinuclear antibodies (ANAs)

remains elusive in the long-term outcome of primary biliary cirrhosis (PBC). The progression of PBC was evaluated in association with ANAs using stepwise proportional hazard regression and

an unconditional stepwise logistic regression model based on the data of 276

biopsy-proven, definite PBC patients who have been registered to the National

Hospital Organization Study Group for Liver Disease in Japan (NHOSLJ). When death of hepatic failure/liver transplantation (LT)

was defined as an end-point, positive anti-gp210 antibodies (Hazard ratio (HR)

= 6.742, 95% confidence interval (CI): 2.408, 18.877), the late stage (Scheuer's stage 3, 4) (HR = 4.285, 95% CI:1.682,10.913) and

male sex (HR = 3.266, 95% CI: 1.321,8.075) were significant risk factors at the

time of initial liver biopsy. When clinical

progression to death of hepatic failure/LT (i.e., hepatic failure type

progression) or to the development of esophageal varices or hepatocellular

carcinoma without developing jaundice (Total bilirubin

< 1.5 mg/dL) (i.e., portal hypertension type

progression) was defined as an end-point in the early stage (Scheuer's stage 1, 2) PBC patients, positive anti-gp210

antibodies was a significant risk factor for hepatic failure type progression

[odds ratio (OR) = 33.777, 95% CI: 5.930, 636.745], whereas positive anti-centromere antibodies was a significant risk factor for

portal hypertension type progression (OR = 4.202, 95% CI: 1.307, 14.763). Histologically, positive anti-gp210 antibodies was most

significantly associated with more severe interface hepatitis and lobular

inflammation, whereas positive anticentromere

antibodies was most significantly associated with more severe ductular reaction. Conclusion:

These results indicate 2 different progression types in PBC, hepatic failure

type and portal hypertension type progression, which may be represented by

positive-anti-gp210 and positive-anticentromere

antibodies, respectively. (HEPATOLOGY 2007;45:118-127.).

PMID: 17187436 [PubMed - in process]