The Significance Of Autoantibodies To Asialoglycoprotein Receptor In Characteristics Of Type 1 Autoimmune Hepatitis

Background:Autoi mmune hepatitis is a kind of liver disease of which pathogenesis and etiology are not clear, yet it deals with the autoimmune system of human body. It is characterized by the presence of autoantibodies in the circulation, hypergammaglobulinemia, interface hepatitis on histologic examination, and plasma cell infiltration. In the past, AIH was subcategorized as three types based upon the type of circulating autoantibodies. While in 2010, the new classification made by AASLD is as followed:type 1, antinuclear antibody(ANA) and/or smooth muscle antibody(SMA) are positive) and type 2,antibodies liver/kidney microsome (LKM) 1 and/or 3 and/or anti-liver cytosol 1 (LCI) are positive. Between the two, Type 1 is more common. But the antibodies that help with classification are not specific or able to predict the inflammatory activity. Recent studies have indicated that autoantibody to asialoglycoprotein receptor was specific to autoimmune hepatitis, but the significance of it in characteristics of type 1 autoimmune hepatitis has been reported little clinically. There is no doubt that the analysis of autoantibodies to asialoglycoprotein receptor in autoimmune hepatitis type 1 with clinical, biochemical, immunological, pathological characteristics and treatment response can improve the diagnosis and treatment of autoimmune hepatitis. Objective:To investigate the differences between anti-ASGPR-positive and anti-ASGPR-negative patients with type 1 autoimmune hepatitis.Clinically, biochemically, immunoserologically, genetically, histologicallly and their responses to treatment.Methods:The anti-ASGPR was evaluated in a group of seventy-nine AIH-1 patients by ELISA, and then they were divided into anti-ASGPR-positive group and anti-ASGPR-negative group.Results:1. Fifity-nine (75%) patients were anti-ASGPR-positive. There were 59 patients in anti-ASGPR-positive group, including 52 females and 7 males, with a mean age of 49.1±8.6 years. There were 20 patients in anti-ASGPR-positive group, including 18 females and 2 males, with a mean age of 47.1±7.9 years.2.No significant differences were found between the anti-ASGPR-positive and anti-ASGPR-negative patients in age, gender, symptom,alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutanmy transpeptidase(γ-GT),antinuclear autoantibodies (ANA), smooth muscle autoantibodies (SMA),DR3,DR4.3. Anti-ASGPR-positive patients were diagnosed higher level of serum immunoglobulins G and serum gamma globulin and lower serum C3 than Anti-ASGPR-negative.4. Significant differences were found between the anti-ASGPR-positive and anti-ASGPR-negative patients in CD38,CD138 immunohistochemical staining positive cell number and the grading of pathological inflammation. (P<0.05). There are no difference in the situation of fibrosis comparison, but the positive grouphas more chances to get early cirrhosis and severe fibrosis than negative groupp (48%VS25%). 5. The remission of Anti-ASGPR-positive patients were less than Anti-ASGPR-negative after treatment.(P<0.05).The Anti-ASGPR negative of the remission of Anti-ASGPR-positive patients were higer than the patients without remission(93%VS23%).Conclusions:1. Anti-ASGPR has a higher expression in autoimmune hepatitis 1.2. There is relationship between Anti-ASGPR and severity of autoimmune hepatitis 1.3.Anti-ASGPR has a certain predictability in response to treatment of autoimmune hepatitis 1.