Importance of detection of anti-soluble liver antigen/liver pancreas in autoimmune hepatitis

• Grant number: 11/50352-5
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2011
• End date: May 31, 2013
• Field of knowledge: Biological Sciences - Immunology - Applied Immunology
• Principal Investigator: Eduardo Luiz Rachid Cancado
• Grantee: Eduardo Luiz Rachid Cancado
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Autoimmune hepatitis (AIH) is a chronic liver disease, with a necroinflammatory character of unknown cause, with predorninance in young wornen. Its main characteristics are the presence of interface hepatitis, rosetting of hepatocytes and portal plasma cell infiltration in the liver biopsy, along with hypergamrnaglobulinemia, autoantibody reactivity and response to treatment with corticosteroids and immunosuppressors. The profile of autoantibody reactivity allows the classification of AIH into subgroups with biochernical, clinical, serological and immunogenetic more homogeneous features. Two types of AIH are recognized: type I (with the markers anti-smooth muscle and anti-nuclear antibodies), and type 2 (with the markers anti-liver-kidney microsome type I and anti-liver citosol type I antibodies). Anti-soluble liver antigen/ liver-pancreas antibodies (anti-SLA/LP) were considered as markers of a third type of AIH, occurring in about one third of patients with AIH without serological markers. However, their reactivity in AIH-I and HAI-2 is variable depending on the source of antigen which is used. Current evidence suggests that the anti-SLA/LP do not define a different subgroup of AIH, but their positivity allows the reclassification of patients with cryptogenic hepatitis as AIH and identifies those patients most likely to relapse after discontinuation of corticosteroids. The airns of this study are: a) To determine the frequency of anti-SLA/LP reactivity, using two commercial ELISA kits, in patients with AIH-I, AIH-2 and without serological markers, in chronic liver diseases of different etiologies and in healthy controls, b) To assess whether anti-SLA/LP antibodies can be used as diagnostic markers of AIH. c) To evaluate whether anti-SLA/LP are markers of a third type of AIH. (AU)