汉族原发性胆汁性胆管炎患者抗线粒体抗体M2亚型抗原表位分布及其临床价值

Distribution of antigen epitopes of anti-mitochondrial antibody M2 subtype and its clinical significance for primary biliary cholangitis patients in Chinese Han population

目的探讨汉族原发性胆汁性胆管炎(PBC)患者抗线粒体抗体M2亚型(AMA-M2)抗原表位分布情况及其临床价值。方法采用Red/ET重组技术制备AMA-M2抗原表位蛋白PDC-E2、BCOADC-E2和OGDC-E2,建立相应的ELISA检测方法,对374例PBC患者抗原表位分布进行分析。比较AMA-M2主要抗原表位组合模式间清蛋白-胆红素评分(ALBI)结果的差异,熊去氧胆酸(UDCA)药物生化应答和不应答患者抗原表位分布的差异。结果374例PBC患者血清与PDC-E2、BCOADC-E2和OGDC-E2抗原表位有反应率分别为86.6%、88.0%和35.0%。与PBC患者血清有反应性的常见抗原表位模式(PDC-E2+BCOADC-E2+OGDC-E2、PDC-E2+BCOADC-E2、PDC-E2和BCOADC-E2)间ALBI结果的差异有统计学意义(P<0.05),UDCA生化不应答患者血清与BCOADC-E2的反应率(89.9%)高于应答患者(77.9%),差异有统计学意义(P<0.05)。结论与AMA-M2抗原表位PDC-E2、BCOADC-E2和OGDC-E2同时有反应性的PBC患者疾病预后不佳的风险较高,PDC-E2和BCOADC-E2抗原表位可能与UDCA治疗应答相关。

Objective To investigate the distribution of antigen epitopes of anti-mitochondrial antibody-M2(AMA-M2)and its clinical value for the patients with primary biliary cholangitis(PBC)in Chinese Han population.Methods The epitope proteins of AMA-M2,PCD-E2,BCOADC-E2 and OGDC-E2,were prepared by RED/ET recombinant technique.An ELISA method was established to detect the distribution of epitope proteins in 374 patients with PBC.The differences of albumin-bilirubin(ALBI)score among the various patterns of the main epitopes(combined or single)of AMA-M2 were compared and the differences of the epitope distribution between biochemical responsive and non-responsive patients for ursodeoxycholic acid(UDCA)were also compared.Results The reaction rates of the serum samples from 374 PBC patients with the epitopes PDC-E2,BCoADC-E2 and OGDC-E2 were 86.6%,88.0%and 35.0%,respectively.There were ofThe ALBI scores among the four common patterns of epitope(combined PDC-E2+BCOADC-E2+OGDC-E2 or PDC-E2+BCOADC-E2,single PDC-E2 or BCOADC-E2)reacted to AMA-M2 showed statistically significant differences in most of the serum samples from PBC patients(P<0.05).The reaction rate of the serum samples to epitope BCOADC-E2 in the patients presenting UDCA-biochemical non-response(89.9%)was higher than that in the patients with UDCA response(77.9%)with statistically significant difference(P<0.05).Conclusion The patients whose serum reacted to all the three epitopes(PDC-E2,BCOADC-E2 and OGDC-E2)of AMA-M2 antibodies have showed the high risk of poor prognosis for PBC.The epitopes of PDC-E2 and BCOADCE2 may likely to associate with responses of UDCA treatment.