Autoimmune hepatitis

Clinical information

Autoimmune hepatitis (AIH; previously called lupoid hepatitis, chronic active hepatitis) predominantly affects women (75% of cases). The disease manifests by an increase in bilirubin, liver enzyme and immunoglobulin levels, by characteristic histological changes (liver biopsy shows necrosis of the parenchyma cells with lymphocyte and plasma cell infiltration) and the presence of various autoantibodies. The disease can occur from early childhood up to old age, but is most frequent in young to middle adulthood. In Western Europe the incidence of AIH is 1.9 cases per 100,000 inhabitants per year. Untreated, AIH soon develops into liver cirrhosis. However, with low-dose immunosuppressive therapy administered in good time and consistently for the rest of the patient’s life, life expectancy is normal. The differential diagnosis must include hepatitis virus infection, which must be ruled out through the investigation of the appropriate serological parameters.

Diagnostics

Circulating autoantibodies have come to play a significant role in the diagnosis of AIH. They occur in the majority of patients, although their role in pathogenesis is debatable. There is no clear correlation between the disease activity or prognosis and the antibody titer.

The following autoantibodies are associated with AIH: antibodies against cell nuclei (ANA), native DNA, smooth muscles (ASMA, most important target antigen: F-actin), SLA/LP, liver-kidney microsomes (LKM-1, target antigen: cytochrome P450 IID6) and liver cytosolic antigen type 1 (LC-1, target antigen: formiminotransferase cyclodeaminase). Of all of the antibodies, autoantibodies against SLA/LP, which can today be detected by various EUROIMMUN enzyme immunoassays, have the highest specificity for AIH. Anti-SLA/LP antibodies occur in AIH either alone or together with other autoantibodies. Their prevalence is only between 10% and 30%, but the predictive value is almost 100%. Furthermore, high concentrations of antibodies against smooth muscles (ASMA) indicate AIH. A large part of the antibodies is directed against conformational epitopes of F-actin, which are best preserved in frozen tissue sections or tissue cells. In contrast to other ASMA, antibodies against F-actin are a very specific marker for type I AIH. In addition to the determination on triple sections of rat tissue (liver, kidney, stomach; LKS), the cell line VSM47 (vascular smooth muscle) allows to easily and clearly differentiate the microfilamentous (MF) fluorescence patterns from non-MF patterns, thus facilitating the diagnosis of type I AIH using indirect immunofluorescence tests. Our EUROLINE Autoimmune Liver Diseases profiles are multiparametric line blots that enable efficient confirmation of all relevant autoantibodies.  


Products

Filter techniques:

Method
Parameter
Substrate
Species
EUROLINE
positive control serum: IgG, human, 100x concentrated
for DL 1300-X G
EUROASSAY
AMA M2, LKM-1, SLA/LP
EUROASSAY strip
with antigens
IIFT
Liver Mosaic 1
liver-kidney microsomes (LKM), ANA
mitochondria (AMA), LKM
2 BIOCHIPs per field:
liver
kidney

rat
rat
EUROLINE
Liver Profile 2
(AMA M2, M2-3E, LKM-1, LC-1, SLA/LP separately)
EUROLINE
IIFT
Liver Sreen 1
mitochondria (AMA), LKM
soluble liver antigen/
liver-pancreas antigen (SLA/LP)
LKM, ANA
smooth muscles (ASMA)
4 BIOCHIPs per field:
kidney
transfected cells

liver
stomach

rat
EU 90

rat
rat
EUROASSAY
Liver Profile
AMA M2, LKM-1, LC-1, SLA/LP
EUROASSAY strip
with antigens
EUROLINE
Liver Profile
(AMA M2, LKM-1, LC-1, SLA/LP separately)
EUROLINE
EUROLINE
Autoimmune Liver Diseases
(AMA M2, M2-3E, Sp100, PML, gp210,
LKM-1, LC-1, SLA/LP, Ro-52 separately)
EUROLINE
EUROLINE
Autoimmune Liver Diseases 14 Ag
(AMA-M2, M2-3E, Sp100, PML, gp210,
LKM-1, LC-1, SLA/LP, SS-A, Ro-52, Scl-70,
CENP A, CENP B, PGDH separately)
EUROLINE
IIFT
Liver Mosaic 8
liver antigens, cell nuclei (ANA)
F-actin
cell nuclei (ANA)
LKM, ANA
mitochondria (AMA), LKM
smooth muscles (ASMA)
6 BIOCHIPs per field:
liver
VSM47
HEp-2 cells
liver
kidney
stomach

monkey
rat
human
rat
rat
rat
EUROLINE
Autoimmune Liver Diseases 9 Ag plus F-Actin
(AMA-M2, M2-3E, Sp100, PML, gp210,
LKM-1, LC-1, SLA/LP, F-Aktin und Ro-52)
EUROLINE
IIFT
Liver Mosaic 9
mitochondria (AMA), LKM
LKM, ANA
smooth muscles (ASMA)
F-actin
4 BIOCHIPs per field:
kidney
liver
stomach
VSM47

rat
rat
rat
rat
IIFT
Autoimmune liver diseases Screen 9
EUROPattern
mitochondria (AMA), LKM
LKM, ANA
smooth muscles (ASMA)
F-actin
4 BIOCHIPs per field:

kidney
liver
stomach
VSM47


rat
rat
rat
rat
EUROASSAY
SLA/LP
EUROASSAY strip
with antigens
ELISA
soluble liver antigen/
liver-pancreas antigen (SLA/LP)
antigen-coated
microplate wells
IIFT
soluble liver antigen/
liver-pancreas antigen (SLA/LP)
transfected cells
control transfection
(2 BIOCHIPs per field)
EU 90
EU 90
ELISA
cytosolic
liver antigen type 1
(LC-1)
antigen-coated
microplate wells
IIFT
antibodies against liver-kidney microsomes
(LKM ab control)
ChLIA
IDS Liver Control Set 1
3 x 1.0mL Control 1/2
ELISA
liver-kidney microsomes
(LKM-1)
antigen-coated
microplate wells
ChLIA
IDS LKM-1 1
antigenic coated magnetic particles
IIFT
antibodies against F-actin
IIFT
F-actin
VSM47
rat
IIFT
F-actin EUROPattern
VSM47
rat
IIFT
antibodies against smooth muscles
(ASMA control)
IIFT
smooth muscles
(ASMA)
stomach
rat
IIFT
smooth muscles (ASMA)
F-actin
stomach
VSM47
(2 BIOCHIPs per field)
rat
rat
IIFT
Mosaic Basic Profile 1
cell nuclei (ANA)
mitochondria (AMA)
smooth muscles (ASMA)
3 BIOCHIPs per field:
HEp-2 cells
kidney
stomach

human
rat
rat
IIFT
Mosaic Basic Profile 2
cell nuclei (ANA), LKM
mitochondria (AMA), LKM
smooth muscles (ASMA)
3 BIOCHIPs per field:
liver
kidney
stomach

rat
rat
rat
IIFT
Mosaic Basic Profile 2 EUROPattern
cell nuclei (ANA), LKM
mitochondria (AMA), LKM
smooth muscles (ASMA)
3 BIOCHIPs per field:
liver
kidney
stomach

rat
rat
rat
IIFT
Mosaic Basic Profile 3
cell nuclei (ANA)
cell nuclei (ANA)
mitochondria (AMA)
smooth muscles (ASMA)
4 BIOCHIPs per field:
HEp-2 cells
liver
kidney
stomach

human
monkey
rat
rat
IIFT
Mosaic Basic Profile 3A
cell nuclei (ANA)
cell nuclei (ANA)
mitochondria (AMA)
smooth muscles (ASMA)
4 BIOCHIPs per field:
HEp-20-10 cells
liver
kidney
stomach

human
monkey
rat
rat
IIFT
Mosaic Basic Profile 3A EUROPattern
cell nuclei (ANA) EUROPattern
cell nuclei (ANA)
mitochondria (AMA)
smooth muscles (ASMA)
4 BIOCHIPs per field:
HEp-20-10 cells
liver
kidney
stomach

human
monkey
rat
rat
IIFT
Mosaic Basic Profile 3C
cell nuclei (ANA)
cell nuclei (ANA), LKM
mitochondria (AMA), LKM
smooth muscles (ASMA)
4 BIOCHIPs per field:
HEp-20-10 cells
liver
kidney
stomach

human
rat
rat
rat
IIFT
Mosaic Basic Profile 3C EUROPattern
cell nuclei (ANA), EUROPattern
cell nuclei (ANA), LKM
mitochondria (AMA), LKM
smooth muscles (ASMA)
4 BIOCHIPs per field:
HEp-20-10 cells
liver
kidney
stomach

human
rat
rat
rat
1Product manufactured by third party. Please contact your local EUROIMMUN representative for more information.
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