High prevalence of antibodies to calreticulin of the IgA class in primary biliary cirrhosis: a possible role of gut-derived bacterial antigens in itsaetiology?

Citation
W. Kreisel et al., High prevalence of antibodies to calreticulin of the IgA class in primary biliary cirrhosis: a possible role of gut-derived bacterial antigens in itsaetiology?, SC J GASTR, 34(6), 1999, pp. 623-628
Citations number
46
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
ISSN journal
00365521 → ACNP
Volume
34
Issue
6
Year of publication
1999
Pages
623 - 628
Database
ISI
SICI code
0036-5521(199906)34:6<623:HPOATC>2.0.ZU;2-N
Abstract
Background: In a preliminary study we showed that antibodies to the endopla smic reticulum protein calreticulin (CR) occur in primary biliary cirrhosis (PBC) and autoimmune hepatitis type 1 (AM). Since anti-CR antibodies have also been found in patients with infectious diseases, we investigated their prevalence and immunoglobulin classes in patients with Various hepatic and intestinal diseases, hoping to get some information on a possible relation ship between an infectious trigger and the induction of a certain class of anti-CR antibodies. Methods: Sera were tested for anti-CR antibodies of the IgA, IgG, and IgM class by Western blotting, using CR isolated from human liver: in autoimmune liver diseases (primary biliary cirrhosis (PBC) (n = 8 6) and autoimmune hepatitis (AIH) type 1 (n = 57)), alcoholic liver cirrhos is (ALC) (n = 32), viral Liver infections (acute hepatitis A (n = 8), acute hepatitis B (n = 20), and chronic hepatitis C (n = 28)), and intestinal di seases (Crohn disease (CD) (n = 30), acute yersiniosis (n = 26)). Sera from 100 healthy individuals served as negative controls. Results: The most pro minent finding was the high prevalence of anti-CR antibodies of the IgA cla ss and the similarity in the anti-CR antibody class pattern in PBC (IgA, 62 %; IgG, 43%; IgM, 55%) and yersiniosis (IgA, 62%; IgG, 39%; IgM, 42%). Clas s IgA anti-CR antibodies also occurred frequently in ALC (IgA, 44%; IgG, 41 %; IgM, 19%). In contrast, in AIH anti-CR antibodies were predominantly of class IgG (IgA, 28%; IgG, 60%; IgM, 33%). In hepatitis A anti-CR antibodies were absent. In the other diseases they had a low prevalence and were most ly of class IgG (acute hepatitis B: IgA, 0%; IgG, 15%; IgM, 0%; chronic hep atitis C: IgA, 7%; IgG, 21%; IgM, 0%; CD: IgA, 13%; IgG, 20%; IgM, 13%). Of the healthy individuals 7% had anti-CR antibodies exclusively of class IgG . Conclusions: The high prevalence of anti-CR antibodies of class IgA in pa tients with PBC and yersiniosis as well as in alcoholic liver disease refle cts a reactivity of the gut-associated immune system and could imply that a still undefined gut-derived bacterial (?) agent may trigger PBC.