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Jendrek, ST; Gotthardt, D; Nitzsche, T; Widmann, L; Korf, T; Michaels, MA; Weiss, KH; Liaskou, E; Vesterhus, M; Karlsen, TH; Mindorf, S; Schemmer, P; Bär, F; Teegen, B; Schröder, T; Ehlers, M; Hammers, CM; Komorowski, L; Lehnert, H; Fellermann, K; Derer, S; Hov, JR; Sina, C.
Anti-GP2 IgA autoantibodies are associated with poor survival and cholangiocarcinoma in primary sclerosing cholangitis.
Gut. 2017; 66(1):137-144 Doi: 10.1136/gutjnl-2016-311739
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Schemmer Peter
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Abstract:: Pancreatic autoantibodies (PABs), comprising antibodies against glycoprotein 2 (anti-GP2), are typically associated with complicated phenotypes in Crohn's disease, but have also been observed with variable frequencies in patients with UC. In a previous study, we observed a high frequency of primary sclerosing cholangitis (PSC) in patients with anti-GP2-positive UC. We therefore aimed to characterise the role of anti-GP2 in PSC. In an evaluation phase, sera from 138 well-characterised Norwegian patients with PSC were compared with healthy controls (n=52), and patients with UC without PSC (n=62) for the presence of PABs by indirect immunofluorescence. Further, 180 German patients with PSC served as a validation cohort together with 56 cases of cholangiocarcinoma without PSC, 20 of secondary sclerosing cholangitis (SSC) and 18 of autoimmune hepatitis. Anti-GP2 IgA specifically occurred at considerable rates in large bile duct diseases (cholangiocarcinoma=36%, PSC and SSC about 50%). In PSC, anti-GP2 IgA consistently identified patients with poor survival during follow-up (Norwegian/German cohort: p Log Rank=0.016/0.018). Anti-GP2 IgA was associated with the development of cholangiocarcinoma in both PSC cohorts, yielding an overall OR of cholangiocarcinoma in patients with anti-GP2 IgA-positive PSC of 5.0 (p=0.001). Importantly, this association remained independent of disease duration, bilirubin level and age. Anti-GP2 IgA can be hypothesised as a novel marker in large bile duct diseases. In particular, in PSC, anti-GP2 IgA identified a subgroup of patients with severe phenotype and poor survival due to cholangiocarcinoma. Anti-GP2 IgA may therefore be a clinically valuable tool for risk stratification in PSC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Find related publications in this database (using NLM MeSH Indexing): Adolescent -; Adult -; Aged -; Autoantibodies - blood; Bile Duct Neoplasms - blood; Biomarkers - blood; Case-Control Studies -; Cell Transformation, Neoplastic -; Cholangiocarcinoma - blood; Cholangitis, Sclerosing - blood; Colitis, Ulcerative - blood; Female -; GPI-Linked Proteins - immunology; Hepatitis, Autoimmune - blood; Humans -; Immunoglobulin A - blood; Male -; Middle Aged -; Retrospective Studies -; Risk Factors -; Survival Rate -; Time Factors -; Young Adult -