中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 5
May  2025
Turn off MathJax
Article Contents

Impact of anticentromere antibody on the clinical features and prognosis of patients with primary biliary cholangitis

DOI: 10.12449/JCH250512
Research funding:

National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine (zyyzdxk-2023005)

More Information
  • Corresponding author: ZHOU Guiqin, zhouguiqin@ccmu.edu.cn (ORCID: 0000-0002-1035-0181)
  • Received Date: 2024-09-25
  • Accepted Date: 2024-11-04
  • Published Date: 2025-05-25
  •   Objective  To investigate the impact of anticentromere antibody (ACA) on the clinical features and prognosis of patients with primary biliary cholangitis (PBC) by comparing clinical classification, ursodeoxycholic acid (UDCA) response, GLOBE score, and UK-PBC score between ACA-positive PBC patients and ACA-negative PBC patients.  Methods  A total of 749 patients who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 2013 to December 2022 and were diagnosed with PBC were enrolled and divided into ACA-positive group with 147 patients and ACA-negative group with 602 patients. According to their conditions on admission, the two groups were compared in terms of the distribution of clinical types, i.e., chronic progression-type PBC, portal hypertension-type PBC, and standard jaundice/liver failure-type PBC. There were 261 patients with complete data after 1-year follow-up, among whom there were 53 patients with positive ACA and 208 with negative ACA. A statistical analysis was performed, and propensity score matching was performed based on sex and age at a ratio of 1∶2. The two groups were compared in terms of 1-year UDCA response rate, GLOBE score, and UK-PBC score before and after matching. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups.  Results  Compared with the ACA-negative group, the ACA-positive group had a significantly higher age (61.28±10.35 years vs 56.74±12.17 years, t=4.164, P<0.001), a significantly higher proportion of female patients (93.9% vs 77.6%, χ2=20.221, P<0.001), a significantly higher proportion of patients with portal hypertension (48.3% vs 27.6%, χ2=23.289, P<0.001), and a significantly lower proportion of patients with jaundice/liver failure (24.5% vs 38.5%, χ2=10.205, P<0.001). After 1-year follow-up, for the 261 PBC patients with complete data, there was no significant difference in UDCA response rate before propensity score matching between the ACA-positive group and the ACA-negative group (41.5% vs 41.8%, P>0.05), and there was a significant difference in the proportion of patients with a GLOBE score of >0.3 between the ACA-positive group and the ACA-negative group (92.5% vs 80.3%, χ2=3.935, P=0.047). There were 53 patients in the ACA-positive group and 106 patients in the ACA-negative group after propensity score matching, and there were no significant differences between the two groups in UDCA response rate, GLOBE score, and UK-PBC score (all P>0.05).  Conclusion  ACA-positive patients tend to have an older age, with a higher proportion of female patients or patients with portal hypertension, while there is a relatively low proportion of patients with jaundice/liver failure. Positive ACA has no significant impact on UDCA response rate, GLOBE score, and UK-PBC score.

     

  • loading
  • [1]
    Expert Committee on Hepatology, Doctor Society of Integrative Medicine, Chinese Medical Doctor Association. Experts consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of primary biliary cholangitis[J]. J Clin Hepatol, 2024, 40( 9): 1757- 1766. DOI: 10.12449/JCH240907.

    中国医师协会中西医结合医师分会肝病学专家委员会. 原发性胆汁性胆管炎中西医结合诊疗专家共识[J]. 临床肝胆病杂志, 2024, 40( 9): 1757- 1766. DOI: 10.12449/JCH240907.
    [2]
    YOU H, MA X, EFE C, et al. APASL clinical practice guidance: The diagnosis and management of patients with primary biliary cholangitis[J]. Hepatol Int, 2022, 16( 1): 1- 23. DOI: 10.1007/s12072-021-10276-6.
    [3]
    TRIVEDI PJ, HIRSCHFIELD GM. Recent advances in clinical practice: Epidemiology of autoimmune liver diseases[J]. Gut, 2021, 70( 10): 1989- 2003. DOI: 10.1136/gutjnl-2020-322362.
    [4]
    ZHANG RB, CHEN FJ, HAO WC, et al. Clinical diagnosis of patients with positive anti-centromere antibody[J]. China Pharm, 2021, 30( 15): 99- 101. DOI: 10.3969/j.issn.1006-4931.2021.15.028.

    张若冰, 陈福军, 郝武常, 等. 抗着丝点抗体阳性患者临床诊断研究[J]. 中国药业, 2021, 30( 15): 99- 101. DOI: 10.3969/j.issn.1006-4931.2021.15.028.
    [5]
    LIU BQ. Clinical significance of anti-centromere antibodies in primary biliary cholangitis[D]. Qingdao: Qingdao University, 2023.

    刘秉乾. 抗着丝点抗体在原发性胆汁性胆管炎中的临床意义[D]. 青岛: 青岛大学, 2023.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of primary biliary cholangitis(2021)[J]. J Clin Hepatol, 2022, 38( 1): 35- 41.

    中华医学会肝病学分会. 原发性胆汁性胆管炎的诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38( 1): 35- 41.
    [7]
    KATSUMI T, NINOMIYA M, NISHINA T, et al. miR-139-5p is associated with inflammatory regulation through c-FOS suppression, and contributes to the progression of primary biliary cholangitis[J]. Lab Invest, 2016, 96( 11): 1165- 1177. DOI: 10.1038/labinvest.2016.95.
    [8]
    LAMMERS WJ, HIRSCHFIELD GM, CORPECHOT C, et al. Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy[J]. Gastroenterology, 2015, 149( 7): 1804- 1812. DOI: 10.1053/j.gastro.2015.07.061.
    [9]
    CARBONE M, SHARP SJ, FLACK S, et al. The UK-PBC risk scores: Derivation and validation of a scoring system for long-term prediction of end-stage liver disease in primary biliary cholangitis[J]. Hepatology, 2016, 63( 3): 930- 950. DOI: 10.1002/hep.28017.
    [10]
    QIAO KX, ZHOU GQ, LIU YX, et al. Clinical features of primary biliary cholangitis patients with negative or positive anti-mitochondrial antibody: A comparative study[J]. J Clin Hepatol, 2024, 40( 9): 1778- 1784. DOI: 10.12449/JCH240910.

    乔可欣, 周桂琴, 刘亚兴, 等. 抗线粒体抗体阴性与阳性原发性胆汁性胆管炎患者临床特征比较[J]. 临床肝胆病杂志, 2024, 40( 9): 1778- 1784. DOI: 10.12449/JCH240910.
    [11]
    REN XX, DENG ZH. Research progress of biliary epithelial cells injury in primary biliary cholangitis[J]. Chin J Gastroenterol Hepatol, 2024, 33( 9): 1262- 1266. DOI: 10.3969/j.issn.1006-5709.2024.09.028.

    任茜茜, 邓志华. 原发性胆汁性胆管炎中胆管上皮细胞损伤的研究进展[J]. 胃肠病学和肝病学杂志, 2024, 33( 9): 1262- 1266. DOI: 10.3969/j.issn.1006-5709.2024.09.028.
    [12]
    LU H, ZHANG W. Clinical significance of anticen-tromere antibody in various autoimmune diseses[J]. Chin J Allergy Clin Immunol, 2018, 12( 6): 650- 654. DOI: 10.3969/j.issn.1673-8705.2018.06.010.

    卢慧, 张文. 抗着丝点抗体在多种疾病的临床意义[J]. 中华临床免疫和变态反应杂志, 2018, 12( 6): 650- 654. DOI: 10.3969/j.issn.1673-8705.2018.06.010.
    [13]
    KURAMOTO N, OHMURA K, IKARI K, et al. Anti-centromere antibody exhibits specific distribution levels among anti-nuclear antibodies and may characterize a distinct subset in rheumatoid arthritis[J]. Sci Rep, 2017, 7( 1): 6911. DOI: 10.1038/s41598-017-07137-4.
    [14]
    NAKAMURA M, KOMORI A, ITO M, et al. Predictive role of anti-gp210 and anticentromere antibodies in long-term outcome of primary biliary cirrhosis[J]. Hepatol Res, 2007, 37( Suppl 3): S412- S419. DOI: 10.1111/j.1872-034X.2007.00244.x.
    [15]
    ZHANG ZS, ZHANG YW, DONG XM, et al. Study on the efficacy of alfacalcidol combined with ursodeoxycholic acid in primary biliary cholangitis[J]. Chin J Clin Pharmacol Ther, 2024, 29( 10): 1161- 1167. DOI: 10.12092/j.issn.1009-2501.2024.10.009.

    张梓珊, 张耀武, 董晓明, 等. 阿法骨化醇联合熊去氧胆酸对原发性胆汁性胆管炎的疗效研究[J]. 中国临床药理学与治疗学, 2024, 29( 10): 1161- 1167. DOI: 10.12092/j.issn.1009-2501.2024.10.009.
    [16]
    GAO LL, ZHANG YJ, GAO XS, et al. Analysis of differential expression of lncRNA and mRNA in liver tissue of female primary biliary cholangitis patients with poor response to ursodeoxycholic acid[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 2): 47- 53. DOI: 10.3969/j.issn.1674-7380.2023.02.008.

    高丽丽, 张亦瑾, 高学松, 等. 熊去氧胆酸应答不佳原发性胆汁性胆管炎女性患者肝组织lncRNA、mRNA差异表达分析[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 2): 47- 53. DOI: 10.3969/j.issn.1674-7380.2023.02.008.
    [17]
    LIU W, ZENG ZL, MA L, et al. Analysis on immunological and clinical characteristics of anti centromere antibody positive patients with autoimmunity disease[J]. China J Lepr Skin Dis, 2022, 38( 5): 310- 313.

    刘玮, 曾志良, 马玲, 等. 抗着丝点抗体阳性自身免疫性疾病患者临床及免疫学特征分析[J]. 中国麻风皮肤病杂志, 2022, 38( 5): 310- 313.
    [18]
    SHI XH, ZHANG FC, ZHANG X. Significance of anticentromere antibody in primary biliary cirrhosis[J]. Chin J Rheumatol, 2006, 10( 8): 485- 487.

    史旭华, 张奉春, 张烜. 抗着丝点抗体在原发性胆汁性肝硬化中的意义[J]. 中华风湿病学杂志, 2006, 10( 8): 485- 487.
    [19]
    LAZARIDIS KN, STRAZZABOSCO M, LARUSSO NF. The cholangiopathies: Disorders of biliary epithelia[J]. Gastroenterology, 2004, 127( 5): 1565- 1577. DOI: 10.1053/j.gastro.2004.08.006.
    [20]
    GRESSNER AM, WEISKIRCHEN R. Modern pathogenetic concepts of liver fibrosis suggest stellate cells and TGF-beta as major players and therapeutic targets[J]. J Cell Mol Med, 2006, 10( 1): 76- 99. DOI: 10.1111/j.1582-4934.2006.tb00292.x.
    [21]
    WANG MC, XU AF, TANG XF. Serological and imaging study of positive anti-centromere antibody in patients with primary biliary cirrhosis[J]. Chin J Health Lab Technol, 2018, 28( 7): 827- 829.

    王妙婵, 徐爱芳, 汤晓飞. 抗着丝点抗体阳性原发性胆汁性肝硬化患者血清学及影像学特征分析[J]. 中国卫生检验杂志, 2018, 28( 7): 827- 829.
    [22]
    WANG PZ, HUA WH, LIU Y. The clinical significance of anti-centromere antibody and antinuclear antibody in primary biliary cirrhosis[J]. Beijing Med J, 2012, 34( 6): 441- 444. DOI: 10.15932/j.0253-9713.2012.06.020.

    王培之, 华文浩, 刘颖. 抗着丝点抗体与抗核抗体在原发性胆汁性肝硬化的临床意义[J]. 北京医学, 2012, 34( 6): 441- 444. DOI: 10.15932/j.0253-9713.2012.06.020.
    [23]
    YOU MG. Overview of research on ursodeoxycholic acid[J]. J Pharm Res, 2021, 40( 3): 199- 202. DOI: 10.13506/j.cnki.jpr.2021.03.013.

    尤梅桂. 熊去氧胆酸的研究概况[J]. 药学研究, 2021, 40( 3): 199- 202. DOI: 10.13506/j.cnki.jpr.2021.03.013.
    [24]
    WANG L, KONG F, ZHANG X, et al. Baseline analysis of refractory primary biliary cirrhosis[J]. Natl Med J China, 2012, 92( 41): 2918- 2920. DOI: 10.3760/cma.j.issn.0376-2491.2012.41.010.

    王立, 孔芳, 张烜, 等. 影响难治型原发性胆汁性肝硬化疗效的因素分析[J]. 中华医学杂志, 2012, 92( 41): 2918- 2920. DOI: 10.3760/cma.j.issn.0376-2491.2012.41.010.
    [25]
    RIGAMONTI C. Clinical features and prognosis of primary biliary cirrhosis associated with systemic sclerosis[J]. Gut, 2006, 55( 3): 388- 394. DOI: 10.1136/gut.2005.075002.
    [26]
    PARVEEN S, MORSHED SA, NISHIOKA M. High prevalence of antibodies to recombinant CENP-B in primary biliary cirrhosis: Nuclear immunofluorescence patterns and ELISA reactivities[J]. J Gastroenterol Hepatol, 1995, 10( 4): 438- 445. DOI: 10.1111/j.1440-1746.1995.tb01597.x.
    [27]
    SHI TY, ZHANG LN, CHEN H, et al. Risk factors for hepatic decompensation in patients with primary biliary cirrhosis[J]. World J Gastroenterol, 2013, 19( 7): 1111- 1118. DOI: 10.3748/wjg.v19.i7.1111.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(5)

    Article Metrics

    Article views (1431) PDF downloads(74) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return