自身免疫性肝炎:临床实践中的血清自身抗体。

IF 8.4 2区 医学 Q1 ALLERGY Clinical Reviews in Allergy & Immunology Pub Date : 2022-10-01 DOI:10.1007/s12016-021-08888-9
Benedetta Terziroli Beretta-Piccoli, Giorgina Mieli-Vergani, Diego Vergani
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引用次数: 17

摘要

循环自身抗体是自身免疫性肝炎(AIH)的关键诊断工具,根据国际自身免疫性肝炎组织发布的专门指南进行检测,95%的病例呈阳性。它们也允许区分以抗核和/或抗平滑肌抗体阳性为特征的1型AIH和以抗肝肾微粒体1型和/或抗肝细胞质1型抗体阳性为特征的2型AIH。抗可溶性肝抗原是唯一的AIH特异性自身抗体,在20-30%的1型和2型AIH中均有发现。抗中性粒细胞胞浆抗体在1型AIH中经常呈阳性,也与炎症性肠病和原发性/自身免疫性硬化性胆管炎有关。自身抗体检测的参考方法仍然是在三组组织(啮齿动物的肝脏、肾脏和胃)上进行间接免疫荧光检测,允许检测大多数肝脏相关的反应性,包括那些分子靶抗原未知的自身抗体。值得注意的是,目前对自身抗体临床意义的认识依赖于基于这种技术的研究。然而,免疫荧光需要训练有素的实验室人员,依赖于观察者,并且缺乏标准化,导致正在尝试用自动测定法取代该方法,然而,其灵敏度和特异性需要进一步研究才能作为免疫荧光的可靠替代方法;目前,它们可以作为免疫荧光的补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Autoimmune Hepatitis: Serum Autoantibodies in Clinical Practice.

Circulating autoantibodies are a key diagnostic tool in autoimmune hepatitis (AIH), being positive in 95% of the cases if tested according to dedicated guidelines issued by the International Autoimmune Hepatitis Group. They also allow the distinction between type 1 AIH, characterized by positive anti-nuclear and/or anti-smooth muscle antibody, and type 2 AIH, characterized by positive anti-liver kidney microsomal type 1 and/or anti-liver cytosol type 1 antibody. Anti-soluble liver antigen is the only AIH-specific autoantibody, and is found in 20-30% of both type 1 and type 2 AIH. Anti-neutrophil cytoplasmic antibody is frequently positive in type 1 AIH, being associated also with inflammatory bowel disease and with primary/autoimmune sclerosing cholangitis. The reference method for autoantibody testing remains indirect immunofluorescence on triple tissue (rodent liver, kidney and stomach), allowing both the detection of the majority of liver-relevant reactivities, including those autoantibodies whose molecular target antigens are unknown. Of note, the current knowledge of the clinical significance of autoantibodies relies on studies based on this technique. However, immunofluorescence requires trained laboratory personnel, is observer-dependent, and lacks standardization, leading to ongoing attempts at replacing this method with automated assays, the sensitivity, and specificity of which, however, require further studies before they can be used as a reliable alternative to immunofluorescence; currently, they may be used as complementary to immunofluorescence.

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来源期刊
CiteScore
22.30
自引率
1.10%
发文量
58
审稿时长
6-12 weeks
期刊介绍: Clinical Reviews in Allergy & Immunology is a scholarly journal that focuses on the advancement of clinical management in allergic and immunologic diseases. The journal publishes both scholarly reviews and experimental papers that address the current state of managing these diseases, placing new data into perspective. Each issue of the journal is dedicated to a specific theme of critical importance to allergists and immunologists, aiming to provide a comprehensive understanding of the subject matter for a wide readership. The journal is particularly helpful in explaining how novel data impacts clinical management, along with advancements such as standardized protocols for allergy skin testing and challenge procedures, as well as improved understanding of cell biology. Ultimately, the journal aims to contribute to the improvement of care and management for patients with immune-mediated diseases.
期刊最新文献
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