去唾液酸糖蛋白受体抗体阳性的Ⅰ型自身免疫性肝炎生物学性状及其意义

Biological significance of autoantibodies to asialoglycoprotein receptor in patients with type Ⅰ autoimmune hepatitis

目的:探讨去唾液酸糖蛋白受体抗体(Auto-antibodies to asialoglycoprotein receptor,anti-A S G P R)阳性和阴性Ⅰ型自身免疫性肝炎(type Iauto-immune hepatitis AIH-Ⅰ)在临床、生化、免疫学、遗传学、组织学特点及其治疗应答反应的差异.方法:应用酶联免疫分析法(ELISA)检测79例确诊的AIH-Ⅰ患者血清中anti-ASGPR,将其分为anti-ASGPR阳性组及阴性组.结果:患者中anti-ASGPR阳性的百分比为75%,阳性患者(n=59)中,男性(n=7),女性(n=52),平均年龄(49.1±8.6)岁;阴性患者(n=20)中,男性(n=2),女性(n=18),平均年龄(47.1±7.9)岁,阳性患者与阴性患者在年龄、性别、ALT、AST、ALP、GGT、ANA、S M A、D R3、D R4比较差异无统计学意义,而在IgG、补体C3水平,组织学炎症活动及纤维化程度、治疗应答方面有统计学意义(P<0.05).结论:anti-ASGPR与AIH-Ⅰ患者炎症活动及病理改变存在一致性,且其对治疗应答有一定的提示.

AIM： To investigate the differences in clinical, biochemical, immunoserologic, genetic, histological features and response to treatment between patients with type 1 autoimmune hepatitis （AIH-Ⅰ） who were positive for autoantibodies to asialoglycoprotein receptor （ASGPR） and those negative for anti-ASGPR. METHODS： A total of 79 patients with AIH-Ⅰ were screened for the presence of anti-ASGPR by ELISA and were divided into anti-ASGPR-positive group and anti-ASGPR-negative group. RESULTS： There were 59 patients in the anti-ASGPR-positive group and 20 patients in the anti-ASGPR-positive group. No significant differences were found between anti-ASGPR-positive and-negative patients in age, gender, alanine transaminase （ALT） activity, aspartate aminotransferase （AST） activity, alkaline phosphatase （ALP） activity, gamma glutanmic transpeptidase （γ-GT） activity, antinuclear autoantibodies （ANA）, smooth muscle autoantibodies （SMA）, DR3, and DR4. The levels of immunoglobulin G, C3, histological inflammatory activity and fibrosis, and response to treatment differed significantly between the two groups. CONCLUSION： The presence of anti-ASGPR is correlated, to a certain extent, with inflammatory activity, pathological changes, and response to treatment in patients with AIH-Ⅰ.