Therefore, conserved epitopes across species appear important. While autoantibodies are often organ specific, autoimmunity is commonly tissue specific furthermore, the autoantibodies themselves are usually not species specific. The mechanisms that lead to autoantibody production can differ between individuals with the same disease. There are considerably more autoantibodies than autoimmune diseases, and autoantibodies directed against the same broad antigenic target are not necessarily all identical. In disease, autoantibodies are considered pathological, although it remains unclear whether they are primary or secondary consequences of the underlying processes.
Glucuronyltransferase repressor transfer RNA-associated proteinĪutoantibodies are immunoglobulins that recognize host antigens and may be present from birth without disease association (ie, natural autoantibodies) or occur later in life in response to antigenic stimulation (). Type 1 autoimmune hepatitis, primary sclerosing cholangitis,primary biliary cirrhosis Primary biliary cirrhosis, autoimmune hepatitisįibroblast actin, tubulin and intermediate filaments (general) Type 1 autoimmune hepatitis, primary sclerosing cholangitisĪTPase-associated antigens of the inner mitochondrial membrane Perinuclear antineutrophil cytoplasmic antibodies Type 1 autoimmune hepatitis, primary biliary cirrhosis Le présent article fait le point sur les auto-anticorps sériques actuellement testés en pratique clinique et en recherche et il décrit leur utilité dans les maladies hépatiques chroniques de l’adulte en rappelant leur emploi à bon escient pour le diagnostic et la prise en charge des patients souffrant de maladie du foie auto-immune.Īutoantibodies commonly associated with chronic liver disease Autoantibody Leur présence est parfois considérée comme un synonyme de maladie hépatique auto-immune, ce qui est une interprétation erronée de leur portée clinique. Les auto-anticorps demeurent d’importants outils pour les cliniciens et ont été les premiers marqueurs sérologiques proposés pour aider à faire la distinction entre l’hépatite virale et l’hépatite auto-immune chronique. Il n’en reste pas moins que le diagnostic doit être clair pour qu’on puisse prodiguer un traitement approprié en temps voulu. En l’absence de marqueurs sériques pathognomoniques, le diagnostic repose sur l’examen des résultats d’analyses de laboratoire et souvent, sur une biopsie du foie, et tout doit être interprété dans le contexte clinique voulu, en se rappelant d’écarter les infections virales, les toxicités médicamenteuses et les maladies métaboliques.
Il est difficile de confirmer si un patient souffre de maladie hépatique auto-immune compte tenu de la variabilité des tableaux et de la complexité des définitions. The present article summarizes the serum autoantibodies currently investigated in clinical and research practice, along with a description of their value in adult chronic liver diseases, with an emphasis on their appropriate use in the diagnosis and management of patients with autoimmune liver disease. Their presence is occasionally considered to be synonymous with autoimmune liver disease – a misinterpretation of their clinical significance. Autoantibodies remain important tools for clinicians, and were the first proposed serological markers to aid in differentiating viral from chronic autoimmune hepatitis. However, clear diagnosis is important for appropriate and timely therapy. In the continued absence of pathognomonic serum markers, diagnosis requires evaluation of laboratory investigations and, frequently, a liver biopsy – all of which need to be interpreted in the correct clinical context, with an emphasis on exclusion of viral infections, drug toxicity and metabolic disease. Confirming whether a patient has autoimmune liver disease is challenging, given its varied presentation and complex definitions.