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Updated: Aug 23, 2026
Anti-Nuclear Antibody Screening Using HEp-2 Cells
Published on: June 23, 2014
No prognostic significance of antimitochondrial antibody profile testing in primary biliary cirrhosis
Frank P Vleggaar1, Henk R van Buuren
1Department of Gastroenterology & Hepatology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Insights
Antimitochondrial antibody (AMA) profiles in primary biliary cirrhosis (PBC) do not reliably predict disease progression. Both AMA profile C/D and A/B can be associated with progressive disease, challenging their use as independent prognostic indicators.
Area of Science:
- Hepatology
- Immunology
- Internal Medicine
Background:
- Primary biliary cirrhosis (PBC) exhibits variable disease progression rates among individuals.
- Antimitochondrial antibody (AMA) serological subtyping defines four profiles: A, B, C, and D.
- Previous research suggests AMA profile C/D correlates with progressive PBC, unlike profile A/B, though this remains debated.
Purpose of the Study:
- To investigate the predictive value of AMA profiles for disease course in a Dutch cohort of primary biliary cirrhosis patients.
- To determine if AMA profiles serve as independent prognostic indicators in PBC.
Main Methods:
- Assessment of AMA profiles in serum samples from 38 progressive AMA-positive PBC patients, 31 non-progressive AMA-positive PBC patients (≥6 years), 5 AMA-negative PBC patients, 5 non-PBC decompensated cirrhotics, and 5 healthy volunteers.
- AMA profile determination was performed blinded to clinical data.
Main Results:
- In the progressive AMA-positive PBC group, 13% had profile A/B and 84% had profile C/D.
- In the non-progressive AMA-positive PBC group, 13% had profile A/B, 77% had profile C/D, and 10% had no defined profile.
- No shifts between AMA profiles A/B and C/D were observed during follow-up.
Conclusions:
- The study indicates that both AMA profile C/D and A/B can be associated with progressive primary biliary cirrhosis.
- AMA profiles do not appear to be independent prognostic indicators for PBC disease course.
- Discrepancies with prior studies may stem from differences in patient population selection.
Background/Aims:
The rate of disease progression varies considerably between individuals with primary biliary cirrhosis (PBC). On the basis of serological subtyping 4 antimitochondrial antibody (AMA) profiles (A, B, C and D) can be defined. The finding of previous studies that profile C/D is associated with a progressive course, in contrast to profile A/B, is a question of debate. The aim of the study was to investigate whether AMA profiles predicted the course for a cohort of Dutch PBC patients.
Methodology:
Patients with an established diagnosis of AMA-positive PBC, AMA-negative PBC patients, non-PBC decompensated cirrhotics and healthy volunteers. Serum samples from 38 AMA-positive progressive patients, 31 AMA-positive patients without evidence of progression for at least 6 years, 5 AMA-negative PBC patients, 5 non-PBC decompensated cirrhotics and 5 healthy volunteers were assessed. AMA profiles were determined without knowledge of the clinical data.
Results:
In the progressive AMA-positive group, 13% had profile A/B and 84% had profile C/D. In the non-progressive group, 13% had profile A/B, 77% profile C/D; 10% had no profile. During follow-up, a change from profile A/B to profile C/D or vice versa was not observed.
Conclusions:
This study found that not only PBC patients with AMA profile C/D but also patients with profile A/B may run a progressive course and therefore does not support the suggestion that AMA profiles can be used as independent prognostic indicator. The divergent results of this and previous studies may be explained by the selection of different patient populations.
