PMID- 26061326
OWN - NLM
STAT- MEDLINE
DCOM- 20150825
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 94
IP  - 23
DP  - 2015 Jun
TI  - Prognostic Implications of Antibodies to Soluble Liver Antigen in Autoimmune 
      Hepatitis: A PRISMA-Compliant Meta-Analysis.
PG  - e953
LID - 10.1097/MD.0000000000000953 [doi]
LID - e953
AB  - Prognostic evaluation is important for the management of patients with autoimmune 
      hepatitis (AIH). Although some autoantibodies have been associated with disease 
      activity and outcomes, the implication of antibodies to soluble liver antigen 
      (anti-SLA) remains controversial. To conduct a meta-analysis of observational 
      studies which addressed differences in clinical characteristics by anti-SLA 
      status in patients with AIH. Three databases PUBMED, EMBASE, and OVID were 
      systemically searched up to January 2015 using the terms "soluble liver antigen" 
      or "liver-pancreas antigen" and "autoimmune hepatitis" with restriction to 
      English-language. Studies were included if at least 50 patients with objective 
      diagnosis of AIH were enrolled, anti-SLA detection was performed for the 
      patients, and prognostic outcomes and/or disease severity were reported. Two 
      investigators independently reviewed retrieved literature and evaluated 
      eligibility. Discrepancy was resolved by discussion and a third investigator. 
      Quality of included studies was evaluated using Newcastle-Ottawa Quality 
      Assessment Scale (NOS). Data were pooled using fixed-effect or random-effect 
      models. Prognostic outcomes included death from hepatic failure or requirement 
      for liver transplantation, and responses to immunosuppressive therapy regarding 
      remission or relapse. Results were combined on the odds ratio (OR) or 
      standardized mean difference (SMD) scales. Eight studies were enrolled in this 
      study, involving a total of 1297 AIH patients among whom 195 with anti-SLA. 
      Pooled serum AST levels tended to be lower in anti-SLA seropositive patients. The 
      presence of anti-SLA conferred 3.1-fold increased risk of hepatic death in AIH 
      patients. The remission rates were comparable between anti-SLA seropositive and 
      seronegative AIH patients, while anti-SLA positivity was associated with nearly 
      2-fold increased risk of relapse after drug withdrawal. Human leukocyte antigen 
      (HLA) allotype DR3 was positively associated with anti-SLA. Antibodies to SLA may 
      be an indicator of increased risks of hepatic death and treatment relapse for AIH 
      patients. Our findings suggest that the anti-SLA seropositive patients should be 
      maintained indefinitely on individually adjusted medication to improve their 
      prognosis.
FAU - Chen, Zhi-Xian
AU  - Chen ZX
AD  - From the Department of Clinical Pharmacy, Nantong Health College of Jiangsu 
      Province, China (Z-XC); Center for Liver Diseases, Nantong Third People's 
      Hospital, Nantong University, China (J-GS, YH, L-JW, GQ); and Department of 
      Epidemiology and Medical Statistics, Nantong University, China (YS, JZ).
FAU - Shao, Jian-Guo
AU  - Shao JG
FAU - Shen, Yi
AU  - Shen Y
FAU - Zhang, Jian
AU  - Zhang J
FAU - Hua, Yu
AU  - Hua Y
FAU - Wang, Lu-Jun
AU  - Wang LJ
FAU - Qin, Gang
AU  - Qin G
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Autoantibodies)
RN  - 0 (Autoantigens)
RN  - 0 (liver antigen LA-1)
SB  - IM
MH  - Autoantibodies/blood/*immunology
MH  - Autoantigens/*immunology
MH  - Hepatitis, Autoimmune/blood/*immunology
MH  - Humans
MH  - Prognosis
PMC - PMC4616476
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2015/06/11 06:00
MHDA- 2015/08/26 06:00
PMCR- 2015/06/12
CRDT- 2015/06/11 06:00
PHST- 2015/06/11 06:00 [entrez]
PHST- 2015/06/11 06:00 [pubmed]
PHST- 2015/08/26 06:00 [medline]
PHST- 2015/06/12 00:00 [pmc-release]
AID - 00005792-201506020-00027 [pii]
AID - 10.1097/MD.0000000000000953 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2015 Jun;94(23):e953. doi: 10.1097/MD.0000000000000953.