Analysis of clinical significance of combined antigen screening reagents for autoimmune liver disease

Objective To investigate the clinical significance of combined antigen screening reagents for autoimmune liver disease ( AILD) . Methods A total of 140 patients with liver diseases who visited the Beijing You'an Hospital affiliated to Capital Medical University from September 2011 to September 2012, as well as 30 healthy blood donors and 8 relatives of patients with primary biliary cirrhosis ( PBC) , were included in the study. The serum samples from the 178 subjects were tested by enzyme- linked immunosorbent assay ( ELISA) for detection of AMA- M2, anti- sp100 antibodies, anti- gp210 antibodies, anti- LKM- 1 antibodies, and anti- SLA / LP antibodies, as well as indirect immunofluorescence assay ( IFA) for autoantibodies, immunoblotting ( IB) for antibody profiles, and AMA- M2 ELISA. Results Of the 140 patients tested by screening reagents, 70 ( 50%) had positive results, and 49 of them had strong positive results. Of the 70 positive cases, 61 were positive for ANA and 63 were positive for AMA, as shown by IFA; 21 of the 61 ANA- positive cases had a rim pattern of staining. The IB showed that 16 cases were positive for anti- gp210 antibodies, and 5 cases were negative. The AMA- M2 ELISA showed that 60 of the 63 AMA- positive cases were positive for AMA- M2. Of the 49 strong positive cases, 2 were positive for anti- gp210 antibodies, 5 for anti- sp100 antibodies, 20 for AMA- M2, 12 for both anti- gp210 antibodies and AMA- M2, and 10 for both anti- sp100 antibodies and AMA- M2, as shown by conventional tests. Among the 178 subjects, all the 65 PBC patients were positive for PBC- related antibodies by conventional tests, while 63 of these PBC cases had positive results using the screening reagents, with a coincidence rate of 96. 9% ( 63 /65) ; the number of positive cases detected using conventional reagents was insignificantly higher that determined by screening reagents ( χ2= 0. 016, P > 0. 05) . Four cases tested positive for autoantibodies using screening reagents, but had negative results using conventional reagents. Conclusion The combined antigen screening reagents for AILD have the advantages of high sensitivity, high specificity, easy operation, high efficiency, and low cost, and they can be used in the preliminary screening for AILD.