Overcoming a "probable" diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature.

Pier Luigi Almasio, Marco Liguori, Chiara Bonaguri, Elena Bredi, Paolo Agostinis, Fiorenza Pesente, Ignazio Brusca, Danila Bassetti, Maria Grazia Alessio, Marilina Tampoia, Giovanni Covini, Carlo Selmi, Paolo Muratori, Pietro Invernizzi, Lucia Terzuoli, Brunetta Porcelli, Renato Tozzoli, Danilo Villalta, Elio Tonutti, Floriano RosinaNicola Bizzaro, Antonio Antico, Stefan Platzgummer

Risultato della ricerca: Article

40 Citazioni (Scopus)

Abstract

Serum anti-mitochondrial antibodies (AMA) are the serological hallmark of primary biliary cirrhosis (PBC), yet up to 15% of PBC sera are AMA negative at routine indirect immunofluorescence (IIF) while being referred to as "probable" cases. The diagnostic role of PBC-specific antinuclear antibodies (ANA) remains to be determined. We will report herein data on the accuracy of new laboratory tools for AMA and PBC-specific ANA in a large series of PBC sera that were AMA-negative at IIF. We will also provide a discussion of the history and current status of AMA detection methods. We included IIF AMA-negative PBC sera (n=100) and sera from patients with other chronic liver diseases (n=104) that had been independently tested for IIF AMA and ANA; sera were blindly tested with an ELISA PBC screening test including two ANA (gp210, sp100) and a triple (pMIT3) AMA recombinant antigens. Among IIF AMA-negative sera, 43/100 (43%) manifested reactivity using the PBC screening test. The same test was positive for 6/104 (5.8%) control sera. IIF AMA-negative/PBC screen-positive sera reacted against pMIT3 (11/43), gp210 (8/43), Sp100 (17/43), both pMIT3 and gp210 (1/43), or both pMIT3 and Sp100 (6/43). Concordance rates between the ANA pattern on HEp-2 cells and specific Sp100 and gp210 ELISA results in AMA-negative subjects were 92% for nuclear dots and Sp100 and 99% for nuclear rim and gp210. Our data confirm the hypothesis that a substantial part of IIF AMA-negative (formerly coined "probable") PBC cases manifest disease-specific autoantibodies when tested using newly available tools and thus overcome the previously suggested diagnostic classification. As suggested by the recent literature, we are convinced that the proportion of AMA-negative PBC cases will be significantly minimized by the use of new laboratory methods and recombinant antigens.
Lingua originaleEnglish
Numero di pagine10
RivistaCLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY
Volume42
Stato di pubblicazionePublished - 2012

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Biliary Liver Cirrhosis
Anti-Idiotypic Antibodies
Antibodies
Indirect Fluorescent Antibody Technique
Serum
Antinuclear Antibodies
Enzyme-Linked Immunosorbent Assay
Antigens
Autoantibodies
Liver Diseases
Chronic Disease

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy

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Overcoming a "probable" diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature. / Almasio, Pier Luigi; Liguori, Marco; Bonaguri, Chiara; Bredi, Elena; Agostinis, Paolo; Pesente, Fiorenza; Brusca, Ignazio; Bassetti, Danila; Alessio, Maria Grazia; Tampoia, Marilina; Covini, Giovanni; Selmi, Carlo; Muratori, Paolo; Invernizzi, Pietro; Terzuoli, Lucia; Porcelli, Brunetta; Tozzoli, Renato; Villalta, Danilo; Tonutti, Elio; Rosina, Floriano; Bizzaro, Nicola; Antico, Antonio; Platzgummer, Stefan.

In: CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY, Vol. 42, 2012.

Risultato della ricerca: Article

Almasio, PL, Liguori, M, Bonaguri, C, Bredi, E, Agostinis, P, Pesente, F, Brusca, I, Bassetti, D, Alessio, MG, Tampoia, M, Covini, G, Selmi, C, Muratori, P, Invernizzi, P, Terzuoli, L, Porcelli, B, Tozzoli, R, Villalta, D, Tonutti, E, Rosina, F, Bizzaro, N, Antico, A & Platzgummer, S 2012, 'Overcoming a "probable" diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature.', CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY, vol. 42.
Almasio, Pier Luigi ; Liguori, Marco ; Bonaguri, Chiara ; Bredi, Elena ; Agostinis, Paolo ; Pesente, Fiorenza ; Brusca, Ignazio ; Bassetti, Danila ; Alessio, Maria Grazia ; Tampoia, Marilina ; Covini, Giovanni ; Selmi, Carlo ; Muratori, Paolo ; Invernizzi, Pietro ; Terzuoli, Lucia ; Porcelli, Brunetta ; Tozzoli, Renato ; Villalta, Danilo ; Tonutti, Elio ; Rosina, Floriano ; Bizzaro, Nicola ; Antico, Antonio ; Platzgummer, Stefan. / Overcoming a "probable" diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature. In: CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY. 2012 ; Vol. 42.
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title = "Overcoming a {"}probable{"} diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature.",
abstract = "Serum anti-mitochondrial antibodies (AMA) are the serological hallmark of primary biliary cirrhosis (PBC), yet up to 15{\%} of PBC sera are AMA negative at routine indirect immunofluorescence (IIF) while being referred to as {"}probable{"} cases. The diagnostic role of PBC-specific antinuclear antibodies (ANA) remains to be determined. We will report herein data on the accuracy of new laboratory tools for AMA and PBC-specific ANA in a large series of PBC sera that were AMA-negative at IIF. We will also provide a discussion of the history and current status of AMA detection methods. We included IIF AMA-negative PBC sera (n=100) and sera from patients with other chronic liver diseases (n=104) that had been independently tested for IIF AMA and ANA; sera were blindly tested with an ELISA PBC screening test including two ANA (gp210, sp100) and a triple (pMIT3) AMA recombinant antigens. Among IIF AMA-negative sera, 43/100 (43{\%}) manifested reactivity using the PBC screening test. The same test was positive for 6/104 (5.8{\%}) control sera. IIF AMA-negative/PBC screen-positive sera reacted against pMIT3 (11/43), gp210 (8/43), Sp100 (17/43), both pMIT3 and gp210 (1/43), or both pMIT3 and Sp100 (6/43). Concordance rates between the ANA pattern on HEp-2 cells and specific Sp100 and gp210 ELISA results in AMA-negative subjects were 92{\%} for nuclear dots and Sp100 and 99{\%} for nuclear rim and gp210. Our data confirm the hypothesis that a substantial part of IIF AMA-negative (formerly coined {"}probable{"}) PBC cases manifest disease-specific autoantibodies when tested using newly available tools and thus overcome the previously suggested diagnostic classification. As suggested by the recent literature, we are convinced that the proportion of AMA-negative PBC cases will be significantly minimized by the use of new laboratory methods and recombinant antigens.",
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T1 - Overcoming a "probable" diagnosis in antimitochondrial antibody negative primary biliary cirrhosis: study of 100 sera and review of the literature.

AU - Almasio, Pier Luigi

AU - Liguori, Marco

AU - Bonaguri, Chiara

AU - Bredi, Elena

AU - Agostinis, Paolo

AU - Pesente, Fiorenza

AU - Brusca, Ignazio

AU - Bassetti, Danila

AU - Alessio, Maria Grazia

AU - Tampoia, Marilina

AU - Covini, Giovanni

AU - Selmi, Carlo

AU - Muratori, Paolo

AU - Invernizzi, Pietro

AU - Terzuoli, Lucia

AU - Porcelli, Brunetta

AU - Tozzoli, Renato

AU - Villalta, Danilo

AU - Tonutti, Elio

AU - Rosina, Floriano

AU - Bizzaro, Nicola

AU - Antico, Antonio

AU - Platzgummer, Stefan

PY - 2012

Y1 - 2012

N2 - Serum anti-mitochondrial antibodies (AMA) are the serological hallmark of primary biliary cirrhosis (PBC), yet up to 15% of PBC sera are AMA negative at routine indirect immunofluorescence (IIF) while being referred to as "probable" cases. The diagnostic role of PBC-specific antinuclear antibodies (ANA) remains to be determined. We will report herein data on the accuracy of new laboratory tools for AMA and PBC-specific ANA in a large series of PBC sera that were AMA-negative at IIF. We will also provide a discussion of the history and current status of AMA detection methods. We included IIF AMA-negative PBC sera (n=100) and sera from patients with other chronic liver diseases (n=104) that had been independently tested for IIF AMA and ANA; sera were blindly tested with an ELISA PBC screening test including two ANA (gp210, sp100) and a triple (pMIT3) AMA recombinant antigens. Among IIF AMA-negative sera, 43/100 (43%) manifested reactivity using the PBC screening test. The same test was positive for 6/104 (5.8%) control sera. IIF AMA-negative/PBC screen-positive sera reacted against pMIT3 (11/43), gp210 (8/43), Sp100 (17/43), both pMIT3 and gp210 (1/43), or both pMIT3 and Sp100 (6/43). Concordance rates between the ANA pattern on HEp-2 cells and specific Sp100 and gp210 ELISA results in AMA-negative subjects were 92% for nuclear dots and Sp100 and 99% for nuclear rim and gp210. Our data confirm the hypothesis that a substantial part of IIF AMA-negative (formerly coined "probable") PBC cases manifest disease-specific autoantibodies when tested using newly available tools and thus overcome the previously suggested diagnostic classification. As suggested by the recent literature, we are convinced that the proportion of AMA-negative PBC cases will be significantly minimized by the use of new laboratory methods and recombinant antigens.

AB - Serum anti-mitochondrial antibodies (AMA) are the serological hallmark of primary biliary cirrhosis (PBC), yet up to 15% of PBC sera are AMA negative at routine indirect immunofluorescence (IIF) while being referred to as "probable" cases. The diagnostic role of PBC-specific antinuclear antibodies (ANA) remains to be determined. We will report herein data on the accuracy of new laboratory tools for AMA and PBC-specific ANA in a large series of PBC sera that were AMA-negative at IIF. We will also provide a discussion of the history and current status of AMA detection methods. We included IIF AMA-negative PBC sera (n=100) and sera from patients with other chronic liver diseases (n=104) that had been independently tested for IIF AMA and ANA; sera were blindly tested with an ELISA PBC screening test including two ANA (gp210, sp100) and a triple (pMIT3) AMA recombinant antigens. Among IIF AMA-negative sera, 43/100 (43%) manifested reactivity using the PBC screening test. The same test was positive for 6/104 (5.8%) control sera. IIF AMA-negative/PBC screen-positive sera reacted against pMIT3 (11/43), gp210 (8/43), Sp100 (17/43), both pMIT3 and gp210 (1/43), or both pMIT3 and Sp100 (6/43). Concordance rates between the ANA pattern on HEp-2 cells and specific Sp100 and gp210 ELISA results in AMA-negative subjects were 92% for nuclear dots and Sp100 and 99% for nuclear rim and gp210. Our data confirm the hypothesis that a substantial part of IIF AMA-negative (formerly coined "probable") PBC cases manifest disease-specific autoantibodies when tested using newly available tools and thus overcome the previously suggested diagnostic classification. As suggested by the recent literature, we are convinced that the proportion of AMA-negative PBC cases will be significantly minimized by the use of new laboratory methods and recombinant antigens.

UR - http://hdl.handle.net/10447/81123

M3 - Article

VL - 42

JO - CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY

JF - CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY

SN - 1080-0549

ER -