Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure?

Wei Hong Yang, Jiang Hong Yu, Ayako Nakajima, Donna Neuberg, Keith Lindor, Donald B. Bloch

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background & Aims:: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease with a variable clinical course. Identification of serologic markers associated with increased risk of liver failure would assist in management of PBC patients. The objective of this study was to identify antinuclear antibody (ANA) markers that may be used to predict PBC outcome. Methods: Indirect immunofluorescence was used to identify ANAs in 492 PBC patients. χ 2 and Kaplan-Meier analyses were used to examine the association between ANAs and liver failure. Results: A greater percentage of ANA-positive, compared to ANA-negative, PBC patients developed liver failure (41% vs 25%, P =. 005). The presence of anti-centromere antibodies was associated with liver failure (anti-centromere antibody positive vs negative, 58% vs 33%, P =. 001). The time to liver failure was shorter in ANA-positive, compared with ANA-negative, patients (log rank score 5.8, P =. 02). After 8.9 years (the median follow-up for patients without liver failure), 68% of ANA-positive and 81% of ANA-negative patients were free of liver failure. Anti-centromere antibodies were also associated with a shorter time to liver failure (log rank score 8.4, P =. 004). After 8.9 years, 52% of anti-centromere antibody positive and 74% of anti-centromere antibody negative patients were without liver failure. Conclusions: ANAs in general, and anti-centromere antibodies in particular, are associated with liver failure in PBC. PBC patients with ANAs may be candidates for treatment with experimental therapies to prolong the interval between diagnosis and liver failure. ANA-negative patients, who appear to have a relatively benign clinical course, should perhaps be treated with ursodeoxycholic acid alone.

Original languageEnglish (US)
Pages (from-to)1116-1122
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume2
Issue number12
DOIs
StatePublished - Dec 2004
Externally publishedYes

Fingerprint

Biliary Liver Cirrhosis
Antinuclear Antibodies
Liver Failure
Centromere
Anti-Idiotypic Antibodies
Ursodeoxycholic Acid
Investigational Therapies
Kaplan-Meier Estimate
Indirect Fluorescent Antibody Technique
Liver Diseases

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure? / Yang, Wei Hong; Yu, Jiang Hong; Nakajima, Ayako; Neuberg, Donna; Lindor, Keith; Bloch, Donald B.

In: Clinical Gastroenterology and Hepatology, Vol. 2, No. 12, 12.2004, p. 1116-1122.

Research output: Contribution to journalArticle

Yang, Wei Hong ; Yu, Jiang Hong ; Nakajima, Ayako ; Neuberg, Donna ; Lindor, Keith ; Bloch, Donald B. / Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure?. In: Clinical Gastroenterology and Hepatology. 2004 ; Vol. 2, No. 12. pp. 1116-1122.
@article{25eb1b75c4b44c62a1b4208f2f74560e,
title = "Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure?",
abstract = "Background & Aims:: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease with a variable clinical course. Identification of serologic markers associated with increased risk of liver failure would assist in management of PBC patients. The objective of this study was to identify antinuclear antibody (ANA) markers that may be used to predict PBC outcome. Methods: Indirect immunofluorescence was used to identify ANAs in 492 PBC patients. χ 2 and Kaplan-Meier analyses were used to examine the association between ANAs and liver failure. Results: A greater percentage of ANA-positive, compared to ANA-negative, PBC patients developed liver failure (41{\%} vs 25{\%}, P =. 005). The presence of anti-centromere antibodies was associated with liver failure (anti-centromere antibody positive vs negative, 58{\%} vs 33{\%}, P =. 001). The time to liver failure was shorter in ANA-positive, compared with ANA-negative, patients (log rank score 5.8, P =. 02). After 8.9 years (the median follow-up for patients without liver failure), 68{\%} of ANA-positive and 81{\%} of ANA-negative patients were free of liver failure. Anti-centromere antibodies were also associated with a shorter time to liver failure (log rank score 8.4, P =. 004). After 8.9 years, 52{\%} of anti-centromere antibody positive and 74{\%} of anti-centromere antibody negative patients were without liver failure. Conclusions: ANAs in general, and anti-centromere antibodies in particular, are associated with liver failure in PBC. PBC patients with ANAs may be candidates for treatment with experimental therapies to prolong the interval between diagnosis and liver failure. ANA-negative patients, who appear to have a relatively benign clinical course, should perhaps be treated with ursodeoxycholic acid alone.",
author = "Yang, {Wei Hong} and Yu, {Jiang Hong} and Ayako Nakajima and Donna Neuberg and Keith Lindor and Bloch, {Donald B.}",
year = "2004",
month = "12",
doi = "10.1016/S1542-3565(04)00465-3",
language = "English (US)",
volume = "2",
pages = "1116--1122",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "12",

}

TY - JOUR

T1 - Do antinuclear antibodies in primary biliary cirrhosis patients identify increased risk for liver failure?

AU - Yang, Wei Hong

AU - Yu, Jiang Hong

AU - Nakajima, Ayako

AU - Neuberg, Donna

AU - Lindor, Keith

AU - Bloch, Donald B.

PY - 2004/12

Y1 - 2004/12

N2 - Background & Aims:: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease with a variable clinical course. Identification of serologic markers associated with increased risk of liver failure would assist in management of PBC patients. The objective of this study was to identify antinuclear antibody (ANA) markers that may be used to predict PBC outcome. Methods: Indirect immunofluorescence was used to identify ANAs in 492 PBC patients. χ 2 and Kaplan-Meier analyses were used to examine the association between ANAs and liver failure. Results: A greater percentage of ANA-positive, compared to ANA-negative, PBC patients developed liver failure (41% vs 25%, P =. 005). The presence of anti-centromere antibodies was associated with liver failure (anti-centromere antibody positive vs negative, 58% vs 33%, P =. 001). The time to liver failure was shorter in ANA-positive, compared with ANA-negative, patients (log rank score 5.8, P =. 02). After 8.9 years (the median follow-up for patients without liver failure), 68% of ANA-positive and 81% of ANA-negative patients were free of liver failure. Anti-centromere antibodies were also associated with a shorter time to liver failure (log rank score 8.4, P =. 004). After 8.9 years, 52% of anti-centromere antibody positive and 74% of anti-centromere antibody negative patients were without liver failure. Conclusions: ANAs in general, and anti-centromere antibodies in particular, are associated with liver failure in PBC. PBC patients with ANAs may be candidates for treatment with experimental therapies to prolong the interval between diagnosis and liver failure. ANA-negative patients, who appear to have a relatively benign clinical course, should perhaps be treated with ursodeoxycholic acid alone.

AB - Background & Aims:: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease with a variable clinical course. Identification of serologic markers associated with increased risk of liver failure would assist in management of PBC patients. The objective of this study was to identify antinuclear antibody (ANA) markers that may be used to predict PBC outcome. Methods: Indirect immunofluorescence was used to identify ANAs in 492 PBC patients. χ 2 and Kaplan-Meier analyses were used to examine the association between ANAs and liver failure. Results: A greater percentage of ANA-positive, compared to ANA-negative, PBC patients developed liver failure (41% vs 25%, P =. 005). The presence of anti-centromere antibodies was associated with liver failure (anti-centromere antibody positive vs negative, 58% vs 33%, P =. 001). The time to liver failure was shorter in ANA-positive, compared with ANA-negative, patients (log rank score 5.8, P =. 02). After 8.9 years (the median follow-up for patients without liver failure), 68% of ANA-positive and 81% of ANA-negative patients were free of liver failure. Anti-centromere antibodies were also associated with a shorter time to liver failure (log rank score 8.4, P =. 004). After 8.9 years, 52% of anti-centromere antibody positive and 74% of anti-centromere antibody negative patients were without liver failure. Conclusions: ANAs in general, and anti-centromere antibodies in particular, are associated with liver failure in PBC. PBC patients with ANAs may be candidates for treatment with experimental therapies to prolong the interval between diagnosis and liver failure. ANA-negative patients, who appear to have a relatively benign clinical course, should perhaps be treated with ursodeoxycholic acid alone.

UR - http://www.scopus.com/inward/record.url?scp=11144330639&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=11144330639&partnerID=8YFLogxK

U2 - 10.1016/S1542-3565(04)00465-3

DO - 10.1016/S1542-3565(04)00465-3

M3 - Article

VL - 2

SP - 1116

EP - 1122

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 12

ER -