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PLoS One. 2014 Nov 14;9(11):e112877. doi: 10.1371/journal.pone.0112877. eCollection 2014.

PR3-ANCA: a promising biomarker in primary sclerosing cholangitis (PSC).

Author information

1
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
2
Inova Diagnostics, Inc., San Diego, California, United States of America.
3
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
4
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
5
Centre for Liver Research, NIHR Biomedical Research Unit, University of Birmingham, Birmingham, United Kingdom.
6
Department of General, Transplant and Liver Surgery, Warsaw Medical University, Warsaw, Poland; Liver Research Laboratories, Pomeranian Medical University, Szczecin, Poland.
7
University Health Network, Division of Gastroenterology, Toronto Western Hospital, Toronto, Ontario, Canada.

Abstract

BACKGROUND AND AIMS:

The only recognized biomarker for primary sclerosing cholangitis (PSC) is atypical anti-neutrophil cytoplasmic antibodies (aANCA), which, in addition to having low sensitivity and specificity, is an indirect immunofluorescence (IIF) test lacking the advantages of high throughput and objectivity. Recent reports have shown that antibodies to proteinase-3 (PR3-ANCA) might add diagnostic value in inflammatory bowel disease (IBD), specifically in ulcerative colitis (UC). As PSC is associated with IBD, the objective of this study was to evaluate the frequency and clinical significance of PR3-ANCA in a large cohort of patients.

METHODS:

A total of 244 PSC and 254 control [autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), hepatitis C viral infection (HCV), hepatitis B viral infection (HBV), and healthy controls] sera and their clinical correlations were retrospectively analyzed for PR3-ANCA determined by ELISA and a new chemiluminescence immunoassay (CIA). Testing was also performed for aANCA by IIF.

RESULTS:

When measured by CIA, PR3-ANCA was detected in 38.5% (94/244) of PSC patients compared to 10.6% (27/254) controls (p<0.0001). By ELISA, PR3-ANCA was detected in 23.4% (57/244) of PSC patients compared to 2.7% (6/254) controls (p<0.0001). PR3-ANCA in PSC patients was not associated with the presence or type of underlying IBD, and, in fact, it was more frequent in Crohn's disease (CD) patients with PSC than previously reported in CD alone. PR3-ANCA in PSC measured by CIA correlated with higher liver enzymes.

CONCLUSION:

PR3-ANCA is detected in a significant proportion of PSC patients compared to other liver diseases including PBC and AIH. PR3-ANCA is associated with higher liver enzyme levels in PSC, and is not solely related to underlying IBD.

PMID:
25397578
PMCID:
PMC4232573
DOI:
10.1371/journal.pone.0112877
[Indexed for MEDLINE]
Free PMC Article
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