LTOTests

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

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