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PWE-116 Gp210 and/or sp100 antibodies in primary biliary cirrhosis: predictors of cirrhosis/autoimmune (aih) overlap syndromes?
  1. O Taiwo1,
  2. S Mathew2,3,
  3. J Van Vlymen2,
  4. A Correa2,
  5. SJ Deacock4,
  6. P Berry3,
  7. K Cheent3,
  8. H Lewis3,
  9. A Ala3,5
  1. 1Immunology, Surrey Pathology Partnership
  2. 2Department of Health Care Management and Policy, University of Surrey
  3. 3Gastroenterology and Hepatology, Frimley Park Hospital
  4. 4Immunology, Royal Surrey County Hospital
  5. 5Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK


Introduction Primary Biliary Cirrhosis (PBC) is a progressive cholestatic liver disease, with Anti-mitochondrial antibodies (AMA) found in ∼ 95% of patients. Anti-GP210 and SP100 are suggested as additional markers in AASLD guidance, and may help in predicting disease prognosis. However, the role and benefit of anti-GP210 and SP100 testing in routine clinical practice is unclear.

Method We conducted a retrospective study of all PBC patients (diagnosed according to AASLD criteria), across 3 hospitals in Surrey, England; serving a population 1.1million.

Prospective ELISA testing for GP210 and SP100 antibodies were undertaken on all active PBC-patients in follow-up. Baseline characteristics (laboratory/clinical) and progression during follow-up were analysed and compared between both groups.

Results 51 PBC patients were identified, with anti-GP210/SP100 demonstrated in 14 patients (27%); 9 with anti-SP100, 5 with anti-GP210. Demographic characteristics were similar between both groups: age 64 vs. 61 years, Females 80% vs. 70% in the PBC and GP210/SP100 groups. Consistent with the high sensitivity of AMA in PBC, only 1 (1/51) patient was AMA negative, and also negative for M2, GP210 and SP100.

Baseline cirrhosis (imaging/biopsy) was present in 3/27 patients (11%) in the PBC group vs. 3/12 (25%) in the GP210/SP100 group. Quantitative mean M2 values were similar (100 vs. 96), as were baseline mean laboratory values (Bilirubin, ALT, ALP, GGT and IgM).

Cirrhosis was present at follow-up (range 0.5–10 years) in 5/37 patients (13.5%) vs. 4/13 (31%) in the GP210/SP100 group.

Treatment response to UDCA at one year (Barcelona criteria) was similar: 10/24 (42%) vs. 5/13 (38%) in the GP210/SP100 group. Post-treatment mean alkaline phosphatase levels were higher in the GP210/SP100 group 231 vs. 174 (p = 0.84).

8/51 PBC patients (16%) had diagnosed Autoimmune hepatitis (AIH)/PBC Overlap Syndrome (OS) (based on histological/serological features). OS cases were seen in 2/37 (5%) in the non-ANA group vs. 6/14 (43%) of those in the GP210/SP100 group, reaching statistical significance (p = 0.05); with no significant difference in ALT levels between the OS/non-OS groups.

Conclusion Although a small sample, our findings support the role of anti-GP210/SP100 as possible markers of disease severity (cirrhosis), and suggest a role for these auto-antibodies in identifying patients with PBC/AIH overlap syndromes; even in the absence of a significant transaminitis.

Disclosure of interest None Declared.

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