Antimitochondrial antibody-negative primary biliary cirrhosis: a subset of primary biliary cirrhosis
Version of Record online: 31 JAN 2008
Volume 28, Issue 2, pages 233–239, February 2008
How to Cite
Liu, B., Shi, X. H., Zhang, F. C., Zhang, W. and Gao, L. X. (2008), Antimitochondrial antibody-negative primary biliary cirrhosis: a subset of primary biliary cirrhosis. Liver International, 28: 233–239. doi: 10.1111/j.1478-3231.2007.01651.x
- Issue online: 31 JAN 2008
- Version of Record online: 31 JAN 2008
- Received 11 November 2007accepted 3 December 2007
- antimitochondrial antibody;
- primary biliary cirrhosis
Objective: Antimitochondrial antibodies (AMA) are the hallmark in primary biliary cirrhosis (PBC); nevertheless, it has long been recognized that 5–10% patients with typical features compatible with PBC do not have detectable AMA, and they were referred to as ‘AMA-negative PBC’. This study aimed to evaluate whether AMA-negative/positive PBC represents different clinical entities.
Methods: We compared the clinical, laboratory, percentage of regulatory T cells (Tregs) in peripheral blood, liver biopsy features and response to treatment of the two groups of patients. The first group was comprised of 12 patients with ‘AMA-negative PBC’. The second was made up of another 12 PBC patients with positive AMA.
Results: Antimitochondrial antibodies-negative/positive patients were remarkably similar in terms of clinical manifestations, liver biochemistries and histological findings. The frequency of anti-nuclear antibodies, anti-smooth-muscle antibody, anti-gp210 and anti-sp100 antibody showed no significant difference between the two groups. A significantly lower mean percentage of CD4+CD25high T cells was observed in peripheral blood mononuclear cells of AMA-negative/positive PBC patients compared with that of the 12 control subjects (5.8±1.8 and 5.4±1.4% vs. 7.6±1.7% respectively; P=0.014 and 0.004). However, no difference could be found between AMA-negative and AMA-positive PBC patients (P=0.599). After 1 year treatment with ursodeoxycholic acid, the two groups showed similar response.
Conclusion: Antimitochondrial antibody-negative/positive PBC patients are similar in clinical, laboratory, percentage of Treg in peripheral blood, liver biopsy features and response to treatment. This suggests that AMA-negative PBC may be a variant of AMA-positive PBC rather than a separate clinical entity.