Apolipoprotein E polymorphism, a marker of disease severity in primary biliary cirrhosis?

Background/Aims: To determine whether the apolipoprotein E (apo-E) polymorp hism is associated with the risk of primary biliary cirrhosis (PBC), the se verity of the disease and its response to ursodeoxycholic acid (UDCA) thera py. Methods: The apo-E genotype was determined in 72 PBC patients. Genotype and allele distributions were compared with those found in the French general population. Laboratory parameters obtained before and after 1- and 4-year U DCA treatment were compared according to the apo-E allele carrier status. Results: Apo-E allele and genotype distributions were similar between PBC p atients and the general population. At the time of diagnosis, the epsilon4 allele carriers were younger (P < 0.05), had higher bilirubin (P < 0.05) an d IgG (P < 0.001) levels and a lower prothrombin index (P < 0.01) than epsi lon2 (homozygous + heterozygous) or epsilon3 homozygous allele carriers. Af ter 4-year UDCA therapy, the decrease in serum alkaline phosphatase and in alanine and aspartate aminotransferase activities was lower in percentage i n the epsilon4 than in other epsilon allele carriers (P < 0.01). Conclusions: Although apo-E polymorphism does not appear to confer suscepti bility to PBC, it probably influences PBC progression and response to UDCA. The epsilon4 allele may identify patients with high risk of severe disease and poor response to treatment. (C) 2001 European Association for the Stud y of the Liver. Published by Elsevier Science B.V. All rights reserved.