Autoantibodies reacting with a 4.5s RNA in autoimmune chronic active hepatitis. A new marker?

Autoantibodies reacting with a 4.5s RNA in autoimmune chronic active hepatitis. A new marker?

SEROLOGICAL PROFILE OF ORGAN SPECIFIC AUTOANTIBODIES DURING HEPATITIS DELTA VIRUS INFECTION. R. ESTEBAN, M. BUTI, J:L: RODRIGUEZ*, JS A~ENGUAL*, R. ...

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SEROLOGICAL PROFILE OF ORGAN SPECIFIC AUTOANTIBODIES

DURING HEPATITIS DELTA VIRUS

INFECTION. R. ESTEBAN, M. BUTI, J:L: RODRIGUEZ*, JS A~ENGUAL*, R. JAEDI, L VILADOMIU, J. GDAEDIA. LIVER UNIT. HOSPITAL DEL VALLE HEBRON. I~dUNOLOGY SECTION*, HOSPITAL DE SANT PAU. DNIVERSIDAD AUTONOMA: BARCELONA: SPAIN.

Previous reports have described the presence of organ -speclflc autoantlbodles In pat:ents with hepat,tls D virus infection.ln order to assess their serological profile *n relation to other serological and hlstolog:cal markers of HDV infection we have investigated the presence of autoantlbodles during acute and chronic delta infection. Fifty seven patients with acute hepatlt:s D who have been followed for 6 months, 53 with chron:C delta hepatltis, 50 with acute hepatttls B, and 25 control sera were tested for the presence of antibodies reacting w:th the basal cell layer of rat forestomach (ant :-8CLA) and with rat thvmiC cells by ind:rec~. Immmunofl ourescence. AntI-BCLA a n t l b o d : e s were found In 58~. o f acute h e p a t i t i s D, in 73% chronic hepatitis O and in none o f acute h e p a t i t i s 8 and c o n t r o l s . In a d d i t i o n two p r e v i o u s l y unreported p a t t e r n s o f antl-th'¢m:c a n t i b o d i e s r e a c t i n g with r e t i c u l a r or lymphoc,tlc c e l l s were i d e n t i f i e d :n 33% and 9% o f acute D h e p a t : t l s r e s p e c t i v e l y , and in 13% and 6~ o f chronic D h e p a t i t i s cases. Among p a t : e n t s w:th acute HBV-HDU colnfection these antibodies were detected transiently ( l e s s t h a n f o u r weeks) and a t low t i t e r w h e r e a s in t h o s e w i t h c h r o n i c infection autoantibodv levels tended to be

high and persisted throughout the follow up. Among pat:ents with chron:c infection, organ specific autoant:bodLes were detected :n g2~, o f the 34 intrahepstic HD-Ag and in 68% o f : h e l g llver-HD-Ag negative which suggests autoinmune phenomena o b s e r v e d d u r i n g c h r o n i c delta Infect~on are not related to level of viral replication.

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AUP2OAM~IBODIES REACTING WITH A 4.5s RNA IN AUTOIMMUNE CHRONIC ACTIVE HEPATITIS. A NEW MARKER?. R.Esteban/ JL.~odriguez*, M.Reget, MJ.Amengual*, M.Butf, C.Pic*, J.Guardia. Liver Unit. Department of Internal Medicine. Hospital Vall d'Hebr6n. Universidad Aut6noma and *Immunology Section. Hospital de Sant Pau. BARCELONA. Although the etiology and pathogenesis of autoimmune chronic active hepatitis remain poorly understood, it is generally accepted that this term is applied to a heterogenous group of patients on the basis of serological and clinical features. We describe the finding of a previouslu enreported ant:nuclear antibody in a subset of patients with autoimmune chronic a~tive hepatitis. S a m p l e s from 27 patients with histologically proven chronic active hepatitis of unknown cauS~ and ant:nuclear antibodies were tested by immunoprecipitation of nuclear extracts of P32 labeled mouse Freund leukemia cells. In 3 patients we detected a band corresponding to a 4.5s RNA which has not been previously detected. The anti-RNA positive patients were characterized by their young age at onset (14-14-24 years), very aggresive liver disease both clinically and histologically, and a very poor response to steroid treatment. Although these findings are preliminary, this new autoantibody might be a useful marker to identify a subset of autoimmune chronic active hepatitis patients with a more aggresive disease.

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