Antibodies to soluble liver antigen: an additional marker in type 1 auto-immune hepatitis

Background/Aims: Auto-immune hepatitis patients are divided into two well-d efined subgroups on the basis of immunoserological markers, i.e. anti-actin cable and/or anti-nuclear antibodies for the auto-immune hepatitis type 1, anti-liver/kidney microsome type 1 and/or anti-liver cytosol type 1 for th e autoimmune hepatitis type 2. Controversial antibodies to a soluble liver antigen have been proposed as a diagnostic marker for the putative auto-imm une hepatitis type 3. The aim was to investigate the implication of anti-so luble liver antigen antibodies in the diagnosis of auto-immune hepatitis an d their ability to define auto-immune hepatitis type 3. Methods: Sera from 483 patients with hepatic and non-hepatic diseases, and 102 sera from blood donors were analyzed by an inhibition capture enzyme-li nked immunosorbent assay. Results: Anti-soluble liver antigen antibodies were found in 13 of the 106 (12%) auto-immune hepatitis tape 1 patients and 10 of the 49 (20%) cryptoge nic hepatitis patients tested, in contrast, they were not detected in auto- immune hepatitis type 2 (n=54), primary sclerosing cholangitis (n=37), prim ary biliary cirrhosis (n=52), hepatitis C virus infection (n=105), alcoholi c hepatitis (n=25), various non-hepatic autoimmune disorders (n=55) and in healthy blood donors (n=102), The clinical and biological features of antis oluble liver antigen-seropositive patients were similar to those of auto-im mune hepatitis type 1 and did not distinguish a subgroup of auto-immune hep atitis. Conclusion: The data support the concept that antisoluble liver antigen-pos itive cryptogenic hepatitis is similar to auto-immune hepatitis type I. Ant i-soluble liver antigen antibodies can be considered as an additional and s pecific auto-immune hepatitis type 1 diagnostic marker.