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Anticorpi anti-mitocondriali (AMA) e AMA-M2

Revisore:

Dr.ssa Nicoletta Gallo - Azienda Ospedale - Università Padova Dipartimento Didattico - Scientifico - Assistenziale Integrato (DIDAS), Servizi di Diagnostica Integrata U.O.C. Medicina di Laboratorio

In Sintesi

Perché?

Come sostegno alla diagnosi della colangite biliare primitiva.

Quando?

In caso di risultati alterati degli esami del pannello epatico e/o in presenza di sintomi che il clinico sospetti essere associati a colangite biliare primitiva.

Il campione

Un campione di sangue venoso dal braccio.

La preparazione

No, nessuna.

L'Esame

Questo esame rileva e misura la quantità (titolo) degli anticorpi anti-nucleo (AMA).

I metodi di determinazione  degli AMA sono: l’immunofluorescenza indiretta su cellule HEp-2 o su triplo tessuto (fegato, rene e parete gastrica), i metodi Immunometrici (ELISA, CLIA, FEIA) e infine anche l’immunoblot.

Gli AMA sono autoanticorpi fortemente associati alla presenza di colangite biliare primitiva, denominata un tempo come cirrosi biliare primitiva.
Si tratta di una malattia autoimmune cronica che causa un’infiammazione cronica delle vie biliari e la loro conseguente cicatrizzazione. È una malattia a lento decorso in grado di causare la progressiva distruzione del fegato e l’ostruzione delle vie biliari. L’ostruzione dei dotti biliari porta all’accumulo di sostanze dannose all’interno del fegato con la conseguente formazione di tessuto cicatriziale permanente (cirrosi). La colangite biliare primitiva colpisce perlopiù le donne di età compresa tra i 35 ed i 60 anni e in circa il 90-95% delle persone affette è presente un alto titolo di AMA.
Gli AMA sono autoanticorpi, ossia anticorpi diretti contro antigeni propri dell’organismo di appartenenza. Esistono nove tipi di autoanticorpi AMA, indicati con le sigle da M1 a M9. Di questi, gli anticorpi AMA-M2 e M9 sono associati alla malattia con maggiore frequenza (sono clinicamente significativi). La presenza di AMA di tipo M2 (AMA-M2) nel circolo ematico è particolarmente indicativa di colangite biliare primitiva, mentre gli altri tipi di AMA sono associati ad altre patologie.

Come e Perchè

Quali informazioni è possibile ottenere?

Il test di rilevazione e misura degli anticorpi anti-mitocondrio (AMA) o del tipo AMA-M2 può essere richiesto come sostegno diagnostico della colangite biliare primitiva.

Insieme agli AMA possono essere richiesti altri test, come:

Questi test spesso aiutano la diagnosi di colangite biliare primitiva e la diagnosi differenziale con altre forme di malattie autoimmuni, oltre ad essere un ausilio nella rilevazione dei pazienti nei quali è indicato un intervento di trapianto di fegato.

Domande Frequenti

Quali sono le cause della colangite biliare primitiva?

Le cause di colangite biliare primitiva non sono note. Non si tratta né di una malattia infettiva né ereditaria, sebbene possa esserci una predisposizione familiare allo sviluppo di patologie autoimmuni. Nonostante possa colpire entrambi i sessi e di qualsiasi età, è più frequentemente presente in donne di mezza età.

Risorse per i Professionisti

Documenti, Documenti SIBioC e Intersocietari
Estratti Biochimica Clinica (Rivista Ufficiale di SIBioC - Medicina di Laboratorio)

Fonti

Fonti bibliografiche

E.I. Rigopoulou, D.P. Bogdanos. Role of autoantibodies in the clinical management of primary biliary cholangitis World J Gastroenterol 2023 March 28; 29(12): 1795-1810.

doi: 10.3748/wjg.v29.i12.1795

F. Colapietro, A. Lleo, E. Generali. Antimitochondrial antibodies: from bench to bedside. Clinical Reviews in Allergy & Immunology (2022) 63:166–177 doi.org/10.1007/s12016-021-08904-y

M. Sebode, C. Weiler-Normann, T. Liwinski and C. Schramm. Autoantibodies in Autoimmune Liver Disease-Clinical and Diagnostic Relevance. Frontiers in Immunology 2018. doi: 10.3389/fimmu.2018.00609

A. Tanaka. Review Current understanding of primary biliary cholangitis. Clinical and molecular Hepatology 2021;27:1-21. doi.org/10.3350/cmh.2020.0028

 

Pyrsopoulos, N. and Reddy, K. (2016 June 3 Updated). Primary Biliary Cholangitis (Primary Biliary Cirrhosis). Medscape Drugs and Diseases. Available online at http://emedicine.medscape.com/article/171117-overview. Accessed on 02/18/17.

Lal, S. (2016 May 11 Updated). Primary biliary cirrhosis. MedlinePlus Medical Encyclopedia. Available online at https://medlineplus.gov/ency/article/000282.htm. Accessed on 02/18/17.

(2016 December 6, Updated). Primary Biliary Cholangitis (PBC, previously Primary Biliary Cirrhosis). American Liver Foundation. Available online at http://www.liverfoundation.org/abouttheliver/info/pbc/. Accessed on 02/18/17.

Tebo, A. (2016 November Updated). Primary Biliary Cirrhosis – PBC. ARUP Consult. Available online at https://arupconsult.com/content/primary-biliary-cirrhosis. Accessed on 02/18/17.

Shin, Y. (2014 December 5, Updated). Antimitochondrial Antibody. Medscape Laboratory Medicine. Available online at http://emedicine.medscape.com/article/2086548-overview Accessed on 02/18/17.

(2014 April Updated). Primary Biliary Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases Available online at https://www.niddk.nih.gov/health-information/liver-disease/primary-biliary-cirrhosis. Accessed on 02/18/17.

(© 1995–2017). Mitochondrial Antibodies (M2), Serum. Mayo Clinic Mayo Medical Laboratories. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8176. Accessed on 02/18/17.

Fonti utilizzate nelle precedenti revisioni

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO. Pp 82-83.

Lindor, K. (© 2002-2003) What is Primary Biliary Cirrhosis (PBC)? American Liver Foundation [On-line information]. Available online at http://www.liverfoundation.org/db/articles/1014.

(© 1995-2005). Primary Biliary Cirrhosis. The Merck Manual of Medical Information – Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/print/sec10/ch136/ch136d.html.

(© 1995-2005). Primary Sclerosing Cholangitis. The Merck Manual of Medical Information – Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec10/ch136/ch136e.html.

(© 2005). Mitochondrial M2 Antibody, IgG (ELISA). ARUP's Guide to Clinical Laboratory Testing [On-line information]. Available online at http://www.arup-lab.com/guides/clt/tests/clt_a89b.jsp#1142095.

Beuers, U. and Rust, C. (2005 October 27). Overlap Syndromes. Medscape, from Semin Liver Dis. 2005; 25(3): 311-320. [On-line information]. Available online at http://www.medscape.com/viewarticle/512463.

Stone, C. (2004 November 10, Updated). Autoimmune liver disease panel. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003328.htm.

Stone, C. (2004 May 14). Primary biliary cirrhosis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000282.htm.

Peng, S. (2005 April 20). Antimitochondrial antibody. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003529.htm.

(© 2003). Mitochondrial (M2) Antibody. LabCorp [On-line test information]. Available online at http://www.labcorp.com/datasets/labcorp/html/chapter/mono/se000750.htm.

Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 85-86.

Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 272.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition: Saunders Elsevier, St. Louis, MO. Pp 746.

Dugdale, D. (Updated 2008 November 2). Autoimmune liver disease panel. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003328.htm. Accessed 1/29/09.

Christopher-Stine, L. (Updated 2006 August 22). Systemic lupus erythematosus. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000435.htm. Accessed 1/29/09.

Lehrer, J (2006 July 25 Updated). Autoimmune hepatitis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000245.htm. Accessed 1/29/09.

Stone, C. (2008 May 20, Updated). Primary biliary cirrhosis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000282.htm. Accessed 1/29/09.

Hill, H. (Updated 2008 September). Primary Biliary Cirrhosis. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/AutoimmuneDz/PBC.html#. Accessed 1/29/09.

Bylund DJ, Nakamura RM. Organ-specific autoimmune diseases. Henry’s Clinical Diagnosis and Laboratory Management, 21st ed., 2007. Pp 945-960.

(Updated 2012 September 26). Antimitochondrial Antibody. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2086548-overview#showall. Accessed February 2013.

Tebo, A. (Updated 2012 August). Primary Biliary Cirrhosis – PBC. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/PBC.html?client_ID=LTD#tabs=0. Accessed February 2013.

(© 1995–2013). Mitochondrial Antibodies (M2), Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8176. Accessed February 2013.

Makover, M. (Updeate 2011 February 10). Antimitochondrial antibody. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003529.htm. Accessed February 2013.

Pyrsopoulos, N. and Reddy, K. (Updated 2012 January 4). Primary Biliary Cirrhosis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/171117-overview. Accessed February 2013.

Dugdale, D. (Updated 2012 May 1). Primary biliary cirrhosis. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000282.htm. Accessed February 2013.

Shaffer, E. (Reviewed 2009 June) Laboratory Tests of the Liver and Gallbladder. Merck Manual for Healthcare Professionals [On-line information]. Available online through http://www.merckmanuals.com. Accessed February 2013.

Pagana, K. D. & Pagana, T. J. (© 2011). Mosby's Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 87-88.

McPherson, R. and Pincus, M. (© 2011). Henry's Clinical Diagnosis and Management by Laboratory Methods 22nd Edition: Elsevier Saunders, Philadelphia, PA. Pp 304.

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL eds, (2005). Harrison's Principles of Internal Medicine, 16th Edition, McGraw Hill, Pp 1860-1861.

(April 30, 2012) National Digestive Diseases Information Clearinghouse. Primary Biliary Cirrhosis. Available online at http://digestive.niddk.nih.gov/ddiseases/pubs/primarybiliarycirrhosis/index.aspx. Accessed May 2013.

 

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