Z Gastroenterol 2005; 43 - 13
DOI: 10.1055/s-2005-869660

Cholesterol binding antibodies in primary biliary cirrhosis?

T Csak 1, A Folhoffer 1, A Horvath 1, A Bíró 2, P Lakatos 1, J Osztovits 1, T Toth 1, A Habior 3, G Bekő 1, I Tornai 4, I Karádi 2, G Füst 2 F Szalay 1,
  • 11st Dept. of Medicine of Semmelweis University, Budapest, Hungary
  • 23rd Dept. of Medicine of Semmelweis University, Budapest, Hungary
  • 3Medical Center for Postgraduate Education, Warshaw, Poland
  • 41st Dept. of Med. University Debrecen, Hungary

Background: Naturally occurring autoantibodies to cholesterol in humans have been described. Anti-cholesterol antibodies (ACHA) are natural antibodies against the 3beta-OH group of cholesterol. High level ACHA was reported in SLE, HIV and hepatitis C infected patients. ACHA is subject of research in atherosclerosis. Hypercholesterolaemia is common in PBC, although its clinical significance is not fully clarified. We aimed to investigate ACHA and its correlation with lipid and clinical parameters in patients with PBC.

Subjects and Methods: 109 patients with PBC (108F/1M, age: 58.74±9.6 years, each AMA positive) and 61 healthy controls (36F/25M, age: 58.93±9.6) were investigated. ACHA was measured in sera by solid phase enzyme immunoassay as described (Horvath, Atherosclerosis 2001). Correlation between ACHA and serum total cholesterol, LDL and HDL cholesterol and triglyceride (TG) levels, the serum bilirubin level and liver enzymes (AST, ALT, GGT, ALP) was analyzed. Statistical methods: Spearman RO and ANOVA, post hoc Scheffe. ECG was performed.

Results: Higher serum ACHA level was found in patients with PBC (41.8±24.7 AU/ml) compared to healthy controls (28.1±11.4 AU/ml, p=<0.0001). The ACHA values showed an increasing tendency in advanced stages: St. I: 31.0±15.6; St. II: 38.5±16.6; St. III: 56.5±38.4; St. IV:48.3±22.1. Comparing stages III+IV with stages I+II the difference was significant (p=0.013).

The serum cholesterol level was slightly elevated in PBC (total: 6.0±1.1mmol/l), while serum TG level was in the normal range (1.5±0.8 mmol/l). No correlation was found between serum ACHA concentration and either serum cholesterol level, titre of AMA, immunglobulin levels or any liver function test. Although corrected QT interval was slightly increased in PBC patients, it had no correlation with ACHA level.

Conclusion: Our novel finding of elevated serum ACHA in PBC is in concordance with published data on ACHA in SLE, although its significance is not known. Our results on stage-dependent elevation of serum levels of anti-cholesterol antibodies might stimulate further research to clarify the importance of cholesterol and lipoprotein abnormalities in PBC.