serum reactivity against bacterial pyruvate dehydrogenase increasing the specificity of anti-mitochondrial antibodies for the diagnosis of primary biliary cirrhosis血清反应对细菌的丙酮酸脱氢酶增加anti-mitochondrial抗体的特异性诊断原发性胆汁性肝硬化.pdf

Clinical Developmental Immunology, June–December 2006; 13(2–4): 289–294 Serum reactivity against bacterial pyruvate dehydrogenase: Increasing the specificity of anti-mitochondrial antibodies for the diagnosis of primary biliary cirrhosis 1 2 3 1 HIROSHI MIYAKAWA , ATSUSHI TANAKA , CARLO SELMI , NAOMI HOSOYA , 4 1,5 1 1 NORIKAZU MATAKI , KENTARO KIKUCHI , TAKASHI KATO , JUNYA ARAI , TOSHIHIRO GOTO1, M. ERIC GERSHWIN5 1Fourth Department of Internal Medicine, Teikyo University School of Medicine, Kanagawa 213-8507, Japan, 2Department of Medicine, Teikyo University School of Medicine, Tokyo 173-8605, Japan, 3Division of Internal Medicine, Department of Medicine, Surgery and Dentistry, San Pauro School of Medicine, University of Milan, Milan, Italy, 4Second Department of Internal Medicine, National Defense Medical College, Saitama 359-8513, Japan, and 5Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, School of Medicine, Davis, CA, USA Abstract Antimitochondrial antibodies (AMA) are the serum hallmark of primary biliary cirrhosis (PBC). However, AMA-positivity can be found in non-PBC sera when lower dilutions are used, thus raising issues about the specificity and sensitivity of the test. AMA reacts primarily with the lipoylated domains of pyruvate dehydrogenase-E2 (PDC-E2) which is highly conserved across species, including bacteria. We studied 77 serum samples, including 24 from patients with anti-PDC-E2-positive PBC and 53 controls (16 with autoimmune hepatitis (AIH), 10 with primary sclerosing cholangitis (PSC), and 27 healthy individuals) for their reactivities at serial dilutions (1:10, 1:20 and 1:40) against Escherichia coli DH5 alpha lysate o