| Objective: Autoimmune hepatitis(AIH)is an inflammatory disease caused by autoimmune dysfunction of the liver.Numerous studies have shown that accumulated apoptotic cells in the body and deficiency in the clearance of apoptotic cells are all involved in the development of autoimmune diseases represented by autoimmune hepatitis.When apoptotic cells could not be cleared timely from the body,secondary necrosis occurs and F-actin can thereby be released from the cell as a member of damage-associated molecular patterns(DAMPs),which can specifically bind C-type lectin domain family 9 member A(CLEC9A),triggering corresponding autoimmune response.This study aims to investigate the value of F-actin,CLEC9 A and F-actin autoantibodies in the serum of patients with AIH,and to explore the relationships between the relationship between F-actin,CLEC9 A and F-actin autoantibodies and other clinical indicators.Methods: ELISA was established to detect serum levels of F-actin,CLEC9 A and F-actin autoantibodies in 48 patients with AIH which were hospitalized from February 2017 to September 2018(case group),33 patients with primary biliary cholangitis(disease control group)and 39 healthy persons(healthy control group)which were included during the corresponding period,the positive rates of F-actin autoantibodies between the case group and the two control group were compared.The clinical data including age,body weight,Ig G,and transaminase index of 48 patients with AIH were collected and the correlation analysis between F-actin,CLEC9 A and F-actin autoantibodies was applied respectively,correlation analysis between F-actin autoantibodies and F-actin as well as CLEC9 A was done simultaneously.The diagnostic performance of F-actin,CLEC9 A and F-actin autoantibodies in AIH was analyzed respectively by using the receiver operating characteristic curve(ROC).Results: 1.The serum levels of F-actin in the AIH case group,disease control group,and healthy control group were(1.64±1.94),(0.79±0.60),and(0.68±0.70)ng/ml,respectively,the differences between AIH case group and disease control group,and healthy control group were significant(t=2.450,P=0.0165;t=2.959,P=0.0040).F-actin concentration was positively correlated with age,body weight and transaminase level in AIH patients(P<0.05).In the ROC curve,the area under the curve(AUC)was 0.81[95%CI(0.74,0.89)],P<0.0001.Which was statistically significant.When the cut-off value of the F-actin concentration was 0.7535 ng/ml,the Youden’s index(YI)was the largest(YI = 0.47),and the sensitivity for the diagnosis of AIH was 0.65,the specificity was 0.82;2.The serum levels of CLEC9 A in the AIH case group,disease control group,and healthy control group were(1.28±0.64),(0.86±0.26),and(0.77±0.24)ng/ml,respectively,the differences between AIH case group and disease control group,and healthy control group were significant(t=3.568,P=0.0006;t=4.770,P<0.0001).The concentration of CLEC9 A was positively correlated with the level of transaminase in AIH patients(P<0.05).In the ROC curve,the area under the curve(AUC)was 0.80[95%CI(0.71,0.89)],P<0.0001.Which was statistically significant.When the cut-off value of the CLEC9 A concentration was 0.9637 ng/ml,the Youden’s index(YI)was the largest(YI=0.53),and the sensitivity for the diagnosis of AIH was 0.77,the specificity was 0.76;3.The serum levels of F-actin autoantibodies in the AIH case group,disease control group,and healthy control group were(36.27±38.03),(13.17±4.34),and(11.03±5.60)U,respectively,the differences between AIH case group and disease control group,and healthy control group were significant(t=3.468,P=0.0009;t=4.104,P<0.0001).The positive rates of F-actin autoantibodies were 54.17%(26/48)in patients with AIH,9.09%(3/33)in disease control group,and 7.69%(3/39)in healthy control group;the differences between AIH case group and disease control group,and healthy control group were significant(χ~2=17.29,P<0.01;χ~2=20.91,P<0.01).The level of F-actin autoantibodies was positively correlated with CLEC9 A and transaminase levels in AIH patients(P<0.05).In the ROC curve,the area under the curve(AUC)was 0.74[95%CI(0.64,0.84)],P<0.0001.Which was statistically significant.When the cut-off value of the F-actin autoantibodies was 19.51 U,the Youden’s index(YI)was the largest(YI=0.48),and the sensitivity for the diagnosis of AIH was 0.56,the specificity was 0.92.Conclusions: The level of F-actin,CLEC9 A and F-actin autoantibodies in the serum of patients with AIH were higher than that of PBC and healthy controls,so they have certain diagnostic value for AIH;F-actin,CLEC9 A and F-actin autoantibodies levels increase with increasing levels of transaminase,suggesting that they can be used as novel biomarkers to reflect the severity of hepatocytes damage,and can reflect the presence of immune dysfunction in AIH patients. |
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