• Thu. Sep 21st, 2023

This method detects the molecular weight of 50 kDa of SLA protein, which is involved in the regulation of the UGA suppressor tRNA-associated protein


Apr 5, 2023

This method detects the molecular weight of 50 kDa of SLA protein, which is involved in the regulation of the UGA suppressor tRNA-associated protein.[14] Histological Evaluation A local pathologist reviewed the liver tissue and duodenum specimens. a gluten-free diet (GFD), immunosuppressive therapy was administered to normalize the LFTs. The second patient presented with elevated LFTs, a high IgG level, and a positive anti-SLA finding. A GFD was initiated, which resulted in an excellent clinical and biochemical response. Seropositivity for AMA in the first patient and anti-SLA in the second patient remained unchanged during follow-up but neither patient developed primary biliary cholangitis or AIH. Despite the high specificity of anti-SLA and AMA, these autoantibodies can be detected in CD without having any clinical relevance. strong class=”kwd-title” Keywords: Antibodies to soluble liver antigen, anti-mitochondrial autoantibodies, autoimmune hepatitis, celiac disease, primary biliary cholangitis Introduction Autoantibodies have an important role in the diagnosis and classification of autoimmune hepatitis (AIH). Type 1 AIH is associated with antinuclear antibodies (ANA) and/or smooth muscle antibodies (SMA), while type 2 AIH includes antibodies to the liver/kidney microsome (anti-LKM-1) and/or liver cytosolic protein type 1.[1C4] However, these autoantibodies are not fully disease-specific, as they are detected in various forms of chronic liver disorders, other immune-mediated diseases, and even in healthy individuals. Conversely, a finding of antibodies to soluble liver antigen (anti-SLA) has been suggested as a highly specific marker for AIH.[5C7] Anti-mitochondrial autoantibodies (AMA) are considered the serological hallmark of primary biliary cholangitis (PBC). Due to the high sensitivity and specificity Demethoxycurcumin of AMA, a liver biopsy is not necessary Demethoxycurcumin for the diagnosis of Rabbit polyclonal to HAtag PBC when AMA and a cholestatic biochemical profile are present.[8,9] Celiac disease (CD) Demethoxycurcumin is a common, chronic, immune-mediated disorder of the small intestine. CD is induced by dietary wheat, barley, and rye.[10] CD is not restricted to the small intestine; it has been recognized to be a multisystem disorder that may affect other organs, such as the nervous system, bones, skin, and the liver. CD may first present with features of liver injury.[11] Seropositivity for autoimmune liver serology is seen in patients with CD and some patients are diagnosed with co-existing AIH, PBC, or primary sclerosing cholangitis.[10,11] Gastroenterologists need to consider CD in the differential diagnosis of abnormal liver tests and be aware of associated autoimmune liver disorders. In this study, two cases of CD associated with AMA and anti-SLA, both highly specific markers for PBC and AIH are presented. Diagnostic pitfalls for CD patients who have autoimmune liver serology are also discussed. Our findings may help gastroenterologists better understand the diagnostic complexity of CD and associated or coexisting autoimmune liver diseases. Case Report The study was performed using medical data from Hacettepe University and Gazi Ya?argil Education and Research Hospital. The diagnosis of AIH was made according to the simplified criteria suggested by the International Autoimmune Hepatitis Group.[12] Treatment of AIH was assessed according to the American Association for the Study of Liver Disease guidelines. Normalization of serum aminotransferases and immunoglobulin (Ig) G levels has been defined as a complete biochemical response.[1] CD was diagnosed based on serology and duodenal biopsy findings while patients had a diet that contained gluten.[13] The ethics committee of Diyarbak?r Gazi Ya?argil Education and Research Demethoxycurcumin Hospital approved this study. Serological Assessment ANA, SMA, LKM-1, anti-SLA, and AMA with the M2 fraction were assessed using an immunoblotting technique. A titer of 1/40 or above for AMA-M2 was considered positive when the indirect immunofluorescence technique was applied. A commercially available enzyme-linked immunosorbent assay (ELISA) was used to detect IgA and IgG anti-tissue transglutaminase (tTG) antibody levels. To detect anti-SLA, the commercially available Euroline liver profile kit (Euroimmun, Lubeck, Germany) was used. The test was performed using a recombinant SLA antigen. This method detects the molecular weight of 50 kDa of SLA protein,.