Osman Yüksekyayla, Nabi Kina, Arjen Ulaba, Mehmet Emin Ergün, Ersin Batibay, Cem Şimşek, Fadile Yildiz Zeyrek, Staffan Wahlin, Cumali Efe
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Anti-SLA/LP was detected in 20% ( n = 12) of the patients. Baseline characteristics, treatment responses and outcomes were similar among anti-SLA/LP-positive and anti-SLA/LP-negative AIH patients. Anti-SLA/LP-positive patients had significantly higher biochemical response rates after 4 weeks (100 vs. 67%, P = 0.027), 3 months (100 vs. 39%, P < 0.001), 6 months (100 vs. 69%, P = 0.041) of therapy but not after 12 months (100 vs. 76%, P = 0.103) and at the end of follow-up (100 vs. 91%, P = 0.328). Relapse rates following treatment response were similar in patients with and without anti-SLA/LP (22 vs. 23%, P = 0.956). Second-line therapies (tacrolimus and mycophenolate mofetil) were given to seven (11%) patients, all were anti-SLA/LP-negative. Two of these progressed into end-stage liver disease and both underwent liver transplantation.</p><p><strong>Conclusion: </strong>Our study results suggest that anti-SLA/LP positivity does not entail clinically distinct or severe features in AIH. 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引用次数: 0
摘要
背景和目的:可溶性肝抗原/肝胰腺抗体(anti-SLA/LP)是自身免疫性肝炎(AIH)的特异性标志物,与独特的临床表型和更具侵袭性的AIH形式有关。我们对土耳其 AIH 患者中抗 SLA/LP 的频率和临床意义进行了前瞻性评估:我们前瞻性地纳入了 2018 年 1 月至 2023 年 5 月期间确诊为 AIH 的患者。采用免疫荧光和免疫印迹法检测自身抗体:我们纳入了 61 名(80%,女性)AIH 患者,诊断时的中位年龄为 31 岁(15-78 岁)。20%的患者(12人)检测出抗SLA/LP。抗SLA/LP阳性和抗SLA/LP阴性AIH患者的基线特征、治疗反应和预后相似。抗SLA/LP阳性患者在4周(100 vs. 67%, P = 0.027)、3个月(100 vs. 39%, P 结论:抗SLA/LP阳性患者的生化应答率明显高于抗SLA/LP阴性患者:我们的研究结果表明,抗-SLA/LP 阳性并不意味着 AIH 具有明显或严重的临床特征。在我们的队列中,抗SLA/LP阳性患者对免疫抑制治疗的反应更快。
The frequency and clinical significance of antibodies to soluble liver antigen/liver pancreas in autoimmune hepatitis: a prospective single-center study.
Background and aims: Soluble liver antigen/liver pancreas antibodies (anti-SLA/LP) are specific markers for autoimmune hepatitis (AIH) that have been associated with a distinct clinical phenotype and a more aggressive form of AIH. We prospectively evaluated the frequency and clinical significance of anti-SLA/LP in Turkish patients with AIH.
Material and methods: We prospectively included patients diagnosed with AIH between January 2018 and May 2023. Autoantibodies were detected using by immunofluorescence and immunoblot.
Results: We included 61 (80%, female) AIH patients with a median age of 31 years (15-78) at the time of diagnosis. Anti-SLA/LP was detected in 20% ( n = 12) of the patients. Baseline characteristics, treatment responses and outcomes were similar among anti-SLA/LP-positive and anti-SLA/LP-negative AIH patients. Anti-SLA/LP-positive patients had significantly higher biochemical response rates after 4 weeks (100 vs. 67%, P = 0.027), 3 months (100 vs. 39%, P < 0.001), 6 months (100 vs. 69%, P = 0.041) of therapy but not after 12 months (100 vs. 76%, P = 0.103) and at the end of follow-up (100 vs. 91%, P = 0.328). Relapse rates following treatment response were similar in patients with and without anti-SLA/LP (22 vs. 23%, P = 0.956). Second-line therapies (tacrolimus and mycophenolate mofetil) were given to seven (11%) patients, all were anti-SLA/LP-negative. Two of these progressed into end-stage liver disease and both underwent liver transplantation.
Conclusion: Our study results suggest that anti-SLA/LP positivity does not entail clinically distinct or severe features in AIH. In our cohort, anti-SLA/LP-positive patients showed a quicker response to immunosuppressive therapy.
期刊介绍:
European Journal of Gastroenterology & Hepatology publishes papers reporting original clinical and scientific research which are of a high standard and which contribute to the advancement of knowledge in the field of gastroenterology and hepatology.
The journal publishes three types of manuscript: in-depth reviews (by invitation only), full papers and case reports. Manuscripts submitted to the journal will be accepted on the understanding that the author has not previously submitted the paper to another journal or had the material published elsewhere. Authors are asked to disclose any affiliations, including financial, consultant, or institutional associations, that might lead to bias or a conflict of interest.