Liver Blot (AMA-M2, M2-E3, Sp100, PML Ag, gp210, LKM-1, LC-1,SLA/LP, RO52)

Immunology

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Description

The liver blot can be used as a confirmatory mechanism for the presence of the antigens if the primary method of detection ( immunofluorescence ) does not give a definitive answer. The blot can also be used to investigate the presence of Sp100, PML antigen, gp210, LC-1, SLA/LP. M2 anti-mitochondrial antibodies are seen in approximately 95% of cases of primary biliary cirrhosis ( PBC ) [2]. They can also be observed in chronic liver disease, systemic sclerosis and rheumatoid arthritis. E3 dihydrolipoamide dehydrogenase binding protein components of M2 anti-mitochondrial antibodies are associated with PBC. Sp100, gp210 and PML antigen are observed as a multiple nuclear dot pattern on immunofluorescence. They can be associated with PBC ( often with Sjogrens syndrome ) and are occasionally observed in SLE and other connective tissue diseases. LKM-1 antibodies are seen in 80% of autoimmune hepatitis type 2 cases and in 7% of hepatitis C patients [2]. LC-1 may be seen in autoimmune hepatitis type 2 often in combination with LKM-1. They may also be observed in autoimmune cholangitis [2]. SLA/LP is a specific marker for autoimmune hepatitis [3]. Ro52 may be seen in patients with systemic sclerosis or myositis, but is of limited clinical significance [1].

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Indications

For the confirmation of auto-antibodies to various liver proteins ( AMA-M2, M2-E3, Sp100, PML Ag, gp210, LKM-1, LC-1, SLA/LP, RO52 ).

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Sample Type

2mL Serum ( Gel 5mL Yellow tube ) or 2mL Plasma ( EDTA, heparin or citrate ). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

A normal result is negative.

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Turnaround Time

Within 10 days

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Testing Frequency

As required

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References

Parker JC, Burlingame RW, Bunn CC. Prevalence of antibodies to Ro52 in a serologically defined population of patients with systemic sclerosis. J Autoimmun Dis. 2009. 6( 2 ):1-6. [Ref 1]
Bogdanos DP, Invernizzi P, Mackay IR. Autoimmune liver serology: current diagnostic and clinical challenges. World Journal of Gastroenterology. 2008. 14( 21 ):3374-3387
PRU Handbook of Autoimmunity. 4th Edition. 2007. [Ref 2]
Baeres M, et al. Establishment of standardised SLA/LP immunoassays: specificity for autoimmune hepatitis, worldwide occurrence and clinical characteristics. Gut. 2002. 51:259-264. [Ref 3]

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See Also

ANA; LKS Substrate

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