The follow-up of asymptomatic persons with antibodies to pyruvate dehydrogenase in adult population samples

Kai E. Kisand, Kaja Metsküla, Kalle V. Kisand, Tiiu Kivik, M. Eric Gershwin, Raivo Uibo

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Purpose. The presence of antimitochondrial antibodies (AMA), the hallmark of primary biliary cirrhosis (PBC), precedes the clinical manifestation of the disease for many years. The main mitochondrial autoantigen is the E2 component of the pyruvate dehydrogenase complex (PDC). The aim of this study was to identify anti-PDC-positive persons from two Estonian populations by different methodologies and to follow up the positive cases. Methods. Enzyme-linked immunosorbent assay (ELISA) tests for antibodies to native PDC and recombinant PDC-E2 fusion protein were performed in 1461 persons (age range, 15-95 years) from Karksi-Nuia (plus 104 volunteers from the neighborhood) and to native PDC in 497 persons (age range, 50-91 years) from Abja-Paluoja (plus 28 volunteers from that neighborhood). Positive cases were tested with an enzyme inhibition assay. Results. We identified 14 asymptomatic persons with antibodies to native PDC and/or recombinant PDC-E2 from these two population samples. Eight of the 14 were available for follow-up. Three of the 8 developed abnormal liver biochemical test results by the ninth year of follow-up. These persons also had, or developed, during the follow-up, a positive AMA immunofluorescence test, inhibitory antibodies to PDC, and anti-PDC of at least IgG and IgA class. Five of the 8 persons with low levels of anti-PDC, of only one immunoglobulin class reacting with only one PDC preparation, did not show any signs of cholestasis or changes in their immunoreactivity during follow-up. Conclusions. A significant number of asymptomatic patients found to have antibodies to PDC are at high risk of developing primary biliary cirrhosis.

Original languageEnglish (US)
Pages (from-to)248-254
Number of pages7
JournalJournal of Gastroenterology
Volume36
Issue number4
DOIs
StatePublished - 2001

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Pyruvate Dehydrogenase Complex
Pyruvic Acid
Oxidoreductases
Antibodies
Dihydrolipoyllysine-Residue Acetyltransferase
Population
Biliary Liver Cirrhosis
Volunteers
Immunoglobulin Isotypes
Cholestasis
Autoantigens
Enzyme Assays
Immunoglobulin A
Fluorescent Antibody Technique
Immunoglobulin G
Enzyme-Linked Immunosorbent Assay

Keywords

  • Antibodies
  • Asymptomatic primary biliary cirrhosis
  • Population study
  • Pyruvate dehydrogenase

ASJC Scopus subject areas

  • Gastroenterology

Cite this

The follow-up of asymptomatic persons with antibodies to pyruvate dehydrogenase in adult population samples. / Kisand, Kai E.; Metsküla, Kaja; Kisand, Kalle V.; Kivik, Tiiu; Gershwin, M. Eric; Uibo, Raivo.

In: Journal of Gastroenterology, Vol. 36, No. 4, 2001, p. 248-254.

Research output: Contribution to journalArticle

Kisand, Kai E. ; Metsküla, Kaja ; Kisand, Kalle V. ; Kivik, Tiiu ; Gershwin, M. Eric ; Uibo, Raivo. / The follow-up of asymptomatic persons with antibodies to pyruvate dehydrogenase in adult population samples. In: Journal of Gastroenterology. 2001 ; Vol. 36, No. 4. pp. 248-254.
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abstract = "Purpose. The presence of antimitochondrial antibodies (AMA), the hallmark of primary biliary cirrhosis (PBC), precedes the clinical manifestation of the disease for many years. The main mitochondrial autoantigen is the E2 component of the pyruvate dehydrogenase complex (PDC). The aim of this study was to identify anti-PDC-positive persons from two Estonian populations by different methodologies and to follow up the positive cases. Methods. Enzyme-linked immunosorbent assay (ELISA) tests for antibodies to native PDC and recombinant PDC-E2 fusion protein were performed in 1461 persons (age range, 15-95 years) from Karksi-Nuia (plus 104 volunteers from the neighborhood) and to native PDC in 497 persons (age range, 50-91 years) from Abja-Paluoja (plus 28 volunteers from that neighborhood). Positive cases were tested with an enzyme inhibition assay. Results. We identified 14 asymptomatic persons with antibodies to native PDC and/or recombinant PDC-E2 from these two population samples. Eight of the 14 were available for follow-up. Three of the 8 developed abnormal liver biochemical test results by the ninth year of follow-up. These persons also had, or developed, during the follow-up, a positive AMA immunofluorescence test, inhibitory antibodies to PDC, and anti-PDC of at least IgG and IgA class. Five of the 8 persons with low levels of anti-PDC, of only one immunoglobulin class reacting with only one PDC preparation, did not show any signs of cholestasis or changes in their immunoreactivity during follow-up. Conclusions. A significant number of asymptomatic patients found to have antibodies to PDC are at high risk of developing primary biliary cirrhosis.",
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T1 - The follow-up of asymptomatic persons with antibodies to pyruvate dehydrogenase in adult population samples

AU - Kisand, Kai E.

AU - Metsküla, Kaja

AU - Kisand, Kalle V.

AU - Kivik, Tiiu

AU - Gershwin, M. Eric

AU - Uibo, Raivo

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N2 - Purpose. The presence of antimitochondrial antibodies (AMA), the hallmark of primary biliary cirrhosis (PBC), precedes the clinical manifestation of the disease for many years. The main mitochondrial autoantigen is the E2 component of the pyruvate dehydrogenase complex (PDC). The aim of this study was to identify anti-PDC-positive persons from two Estonian populations by different methodologies and to follow up the positive cases. Methods. Enzyme-linked immunosorbent assay (ELISA) tests for antibodies to native PDC and recombinant PDC-E2 fusion protein were performed in 1461 persons (age range, 15-95 years) from Karksi-Nuia (plus 104 volunteers from the neighborhood) and to native PDC in 497 persons (age range, 50-91 years) from Abja-Paluoja (plus 28 volunteers from that neighborhood). Positive cases were tested with an enzyme inhibition assay. Results. We identified 14 asymptomatic persons with antibodies to native PDC and/or recombinant PDC-E2 from these two population samples. Eight of the 14 were available for follow-up. Three of the 8 developed abnormal liver biochemical test results by the ninth year of follow-up. These persons also had, or developed, during the follow-up, a positive AMA immunofluorescence test, inhibitory antibodies to PDC, and anti-PDC of at least IgG and IgA class. Five of the 8 persons with low levels of anti-PDC, of only one immunoglobulin class reacting with only one PDC preparation, did not show any signs of cholestasis or changes in their immunoreactivity during follow-up. Conclusions. A significant number of asymptomatic patients found to have antibodies to PDC are at high risk of developing primary biliary cirrhosis.

AB - Purpose. The presence of antimitochondrial antibodies (AMA), the hallmark of primary biliary cirrhosis (PBC), precedes the clinical manifestation of the disease for many years. The main mitochondrial autoantigen is the E2 component of the pyruvate dehydrogenase complex (PDC). The aim of this study was to identify anti-PDC-positive persons from two Estonian populations by different methodologies and to follow up the positive cases. Methods. Enzyme-linked immunosorbent assay (ELISA) tests for antibodies to native PDC and recombinant PDC-E2 fusion protein were performed in 1461 persons (age range, 15-95 years) from Karksi-Nuia (plus 104 volunteers from the neighborhood) and to native PDC in 497 persons (age range, 50-91 years) from Abja-Paluoja (plus 28 volunteers from that neighborhood). Positive cases were tested with an enzyme inhibition assay. Results. We identified 14 asymptomatic persons with antibodies to native PDC and/or recombinant PDC-E2 from these two population samples. Eight of the 14 were available for follow-up. Three of the 8 developed abnormal liver biochemical test results by the ninth year of follow-up. These persons also had, or developed, during the follow-up, a positive AMA immunofluorescence test, inhibitory antibodies to PDC, and anti-PDC of at least IgG and IgA class. Five of the 8 persons with low levels of anti-PDC, of only one immunoglobulin class reacting with only one PDC preparation, did not show any signs of cholestasis or changes in their immunoreactivity during follow-up. Conclusions. A significant number of asymptomatic patients found to have antibodies to PDC are at high risk of developing primary biliary cirrhosis.

KW - Antibodies

KW - Asymptomatic primary biliary cirrhosis

KW - Population study

KW - Pyruvate dehydrogenase

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