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2011, Number 1

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Ann Hepatol 2011; 10 (1)

Does HLA-DR7 differentiate the overlap syndrome of auto-immune hepatitis-primary biliary cirrhosis (AIH-PBC) from those with auto-immune hepatitis type 1?

Coss AE, Granados J, Uribe M, Torre A
Full text How to cite this article

Language: English
References: 19
Page: 28-32
PDF size: 81.76 Kb.


Key words:

Autoimmune hepatitis, Overlap syndrome, Primary biliary cirrhosis, HLA-DR7, Genetic frequency.

ABSTRACT

Introduction. Autoimmune hepatitis (AIH) and overlap-syndrome (OS) are autoimmune liver diseases of unknown etiology. Although HLA-DR3/DR4 plays a susceptibility role in AIH but there is limited information in regard to OS. Objective. Determine the genetic expression of HLA-DR among patients with AIH versus OS in order to establish susceptibility alleles in comparison to healthy controls (HC). Methods. 26 patients with AIH and 15 patients with OS were studied. Ninety-nine healthy historical controls without autoimmunity were evaluated. Patients with AIH and OS were selected based on the international group for the study of AIH criteria and the Chazouilleres criteria for OS. Patients had at least one liver biopsy. Characterization of HLA-DR was extracted from peripheral blood leukocytes. Alleles were obtained for AIH, OS and HC and comparisons were made between groups. Results. There was a significant increase in HLADR3 and DR1 in AIH compared with the HC group (p = 0.04, OR 2.6, 0.87-7.9, 95% CI). In the AIH group there was a decreased frequency in allele HLA-DR8 when compared with HC (p = 0.04, OR 3.2). There were no statistical differences between the genetic frequencies in the OS group compared with HC. However, HLA-DR7 was able to distinguish between OS patients from those with AIH (p = 0.02, OR 9.8, 1.02-233.6, 95% CI). Conclusions. HLA-DR1/DR3 is increased in AIH, but contrary to data reported in AIH, HLA-DR7 frequency is increased in OS, suggesting increased susceptibility which distinguishes patients with AIH from those with OS.


REFERENCES

  1. Doherty DG, Donalson PT, Underhill JA, Farrant JM, Duthie A, Mieli-Vergani G, et al. Allelic sequence variation in the HLA class II genes and proteins in patients with autoimmune hepatitis. Hepatology 1994; 19: 609-15.

  2. Czaja AJ, Strettell MDJ, Thomson LJ, Santrach PJ, Moore SB, Donaldson PT, Williams R. Associations between alleles of the mayor hystocompatibility complex and type 1 autoimmune hepatitis. Hepatology 1997; 25: 317-23.

  3. Lohse AW, Meyer zum Büchenfelde KH, Franz B, Kanzler S, Gerken G, Dienes HP. Characterization of the overlap syndrome of primary biliary cirrhosis (PBC) and autoimmune hepatitis: Evidence for it being a hepatitis form of PBC in genetically susceptible individuals. Hepatology 1999; 29: 1078-84.

  4. Vázquez-García MN, Alaéz C, Olivo A, Debaz H, Pérez-Luque E, Burguete A, Cano S, et al. MHC class II sequences of susceptibility and protection in mexicans with autoinmune hepatitis. J Hepatol 1998; 28: 985-990.

  5. Zepeda-Gomez S, Montaño-Loza A, Zapata-Colindres JC, Paz F, Olivera-Martinez M, López-Reyes A, Granados J, et al. HLA-DR allele frequencies in Mexican mestizos with autoimmune liver diseases including overlap syndromes. Immunol Invest 2009; 38(3-4): 276-83.

  6. Alvarez F, Berg PA, Bianchi FB, Burroughs AK, Cancado EL, Chapman RW, et al. International autoimmune hepatitis group report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999; 31: 929-38.

  7. Chazouillères O, Wendum D, Serfaty L, Montembault S, Rosmorduc O, Poupon R. Primary Biliary Cirrhosis-Autoimmune Hepatitis overlap syndrome: clinical features and response to therapy. Hepatology 1998; 28: 296-301.

  8. Bignon JD, Fernández-Viña M, Arnajz-Villena A, Fauchet R, Weiss E, Powis S, et al. In: Charron D, Fauchet R (eds.). Technical handbook of the twelfth international histocompatibility workshop, HLA et Medicine, Paris: 1996.

  9. Mackay IR, Morris PJ. Association of autoimmune active chronic hepatitis with HL-A1,8. Lancet 1972; 2: 793-5.

  10. Page AR, Sharp HL, Greenberg LJ. Genetic analysis of patients with chronic active hepatitis. J Clin Invest 1975; 56: 530-5.

  11. Williams RM, et al. Increased frequency of HLA-DRw4 in chronic active hepatitis. Vox Sang 1978; 35: 366-9.

  12. Mackay IR, Tait BD. HLA associations with autoimmune type chronic active hepatitis: identification of B8-DRw3 haplotype by family studies. Gastroenterology 1980; 79: 95-8.

  13. Cookson S, et al. Frequency and nature of cytokine gene polimorphisms in type 1 autoimmune hepatitis. Hepatology 1999; 30: 851-6.

  14. Czaja AJ, Cookson S, Constantini PK, Clare M, Underhill JA, Donaldson PT. Cytokine polimorphisms associated with clinical features and treatment outcome in type 1 autoimmune hepatitis. Gastroenterology 1999; 177: 645-52.

  15. Agarwal K, Czaja AJ, Jones DEJ, Donalson PT. CTLA-4 gene polimorphism confers susceptibility to type 1 autoimmune hepatitis. Hepatology 2000; 31: 49-53.

  16. Czaja AJ. Genetic factors affecting the occurrence, clinical phenotype and outcome of autoimmune hepatitis. Clin Gastroenterol & Hepatol 2008; 6: 379-88.

  17. Czaja AJ, Donaldson PT. Genetic susceptibilities for immune expression and liver cell injury in autoimmune hepatitis.

  18. Czaja AJ, Santrach PJ, Moore SB. Shared genetic risk factors in autoimmune liver disease. Dig Dis Sci 2001; 46: 140-7.

  19. Muratori P, Czaja AJ, Muratori L, Pappas G, Maccariello S, Cassini F, et al. Genetic distinctions between autoimmune hepatitis in Italy and North America. World J Gastroenterol 2005; 11(12):1862-6.




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Ann Hepatol. 2011;10