Investigation on the response to Ursodeoxycholic acid in primary biliary cholangitis patients with positive anti-hexokinase 1 antibodies and anti-kelch-like 12 antibodies / 中华风湿病学杂志

ABSTRACT

Objective:To investigate the value of anti-hexokinase1 antibodies (anti-HK-1) and anti-kelch-like 1 antibodies (anti-KLHL12) antibody in evaluating ursodeoxycholic acid (UDCA) response in patients with primary biliary cholangitis (PBC).Methods:112 PBC patients who had been treated with UDCA for more than 12 months with relatively complete clinical data were analyzed. Serum was collected and the expression of anti-mitochondrial antibody (AMA), anti-HK-1 and anti-KLHL12 antibodies were detected by ELISA. The response to UDCA was based on Paris standard. According to the expression of new antibodies, the patients were divided into the new antibody positive group and negative group. In addition, PBC related baseline indicators were collected, and Spearman correlation analysis was used to study the correlation between antibody expression and baseline indicators in PBC patients.Results:Positivity of anti-HK1 and anti-KLHL12 antibody in AMA-positive PBC patients were 44.7% and 41.2% respectively. Positivity of anti-HK1 and anti-KLHL12 antibodies in AMA negative PBC patients were 33.3% and 22.2%. Anti-HK1 positive patients had higher serum levels of Alaninetransaminase (ALP), aspartate aminotransferase, (AST), γ-glutamyl transpeptidase (γ-GT) and total bilirubin (TBIL) compared with anti-HK1 negative patients, with statistical significant differences ( P<0.05). Notably, correlation analysis showed significantly positive correlation between anti-HK1 antibody expression and ALP, γ-GT and TBIL serum levels ( r=0.735, P<0.05; r=0.332, P<0.05; r=0.491, ( r=0.466, P<0.05). The UDCA response rate in anti-HK-1 antibody positive group was lower than that of the negative group (36.2% vs 60%; P<0.05). Conclusion:Anti-HK-1 and anti-KLHL12 antibody can help to diagnose PBC, and the expression of anti-HK-1 antibody is correlated with the severity of PBC, which could help to predict the reaction of PBC patients to UDCA.