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. 2020 Nov 12;15(11):e0242164.
doi: 10.1371/journal.pone.0242164. eCollection 2020.

Clinical significance of IgG antimitochondrial M2 antibody levels in primary biliary cholangitis: A single center study from China

Lina Feng  1 , Kaihui Dong  2 , Xiaoxue Zhang  1 , Bo Ma  1 , Lin Chen  1 , Qianqian Yang  1 , Qingling Chen  1 , Xiaoyu Wen  1 , Qinglong Jin  1
Affiliations

Clinical significance of IgG antimitochondrial M2 antibody levels in primary biliary cholangitis: A single center study from China

Lina Feng et al. PLoS One. .

Abstract

Background and objective: The relationship between antimitochondrial antibody (AMA) levels and the severity or prognosis of primary biliary cholangitis (PBC) is unclear. This study explored the clinical significance of serum IgG antimitochondrial M2 antibody (IgG-M2) levels.

Methods: From 2008 to 2017, a retrospective analysis was conducted with PBC patients who had available quantitative values of serum IgG-M2 levels obtained with ELISA based on triple expression hybrid clones. The patients were divided into two groups based on high and low concentrations of IgG-M2. Baseline parameters, the incidence of adverse events, and prognosis were compared.

Results: Among the 530 PBC patients, the levels of albumin, cholinesterase, hemoglobin, fibrinogen and triglycerides and the red blood cell count were significantly lower in the high-concentration group than in the low-concentration group (n = 263, 49.6%). The red cell distribution width (RDW) and levels of serum immunoglobulin (Ig) G, IgM and IgA were significantly higher in the high-concentration group than in the low-concentration group. Spearman's correlation analysis suggested that the correlation between the above baseline indicators and IgG-M2 levels was statistically significant but weak (r < 0.2, P < 0.05). In total, 203 patients were followed up, of whom 87 (42.9%) were in the high-concentration group. During the median follow-up period of 52 months (range: 28-75), 121 (59.6%) experienced hepatic decompensation, and 37 (18.2%) died or underwent liver transplantation. There was no significant difference in the incidence of complications or survival (log-rank test: P = 0.079) between the two groups. One year after ursodeoxycholic acid (UDCA) treatment, the two groups had similar responses. In addition, the levels of IgG-M2 did not fluctuate significantly during treatment.

Conclusion: IgG-M2 levels were not related to the disease severity, prognosis or efficacy of UDCA. The levels of IgG-M2 did not change significantly during treatment.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Patient flow chart.
Fig 2
Fig 2. Kaplan–Meier plots for transplant-free survival among patients with PBC stratified by IgG-M2 levels.
No significant difference was observed (P<0.05). IgG-M2, IgG antimitochondrial M2 antibody.
Fig 3
Fig 3. Comparison of IgG-M2 levels before and after UDCA treatment.
All data are reported as the median (IQR).
See this image and copyright information in PMC

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