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Primary Biliary Cirrhosis Specific Antinuclear Antibodies in Patients from Spain

TO THE EDITOR: We read with interest the paper by Muratori et al. (1) reporting that, among 83 antimitochondrial antibody (AMA) positive patients with primary biliary cirrhosis (PBC) followed up in Bologna, Italy, 27% had antibodies to the nuclear body sp100 protein, 16% to the nuclear envelope gp210 protein, and 6% to lamin B receptor (LBR), the seropositivity for gp210 being associated with higher levels of alkaline phosphatase, γ -glutamyl transpeptidase, bilirubin, γ -globulin, IgA and IgM levels, and lower levels of albumin. We have tested 40 PBC patients from Barcelona for sp100, gp210, and LBR with the same commercial ELISA used by Muratori et al. (1). Thirteen patients (33%) were positive for gp210, 12 (30%) for sp100—three (7.5%) being gp210/sp100 double positive—none for LBR. Compared to Muratori et al.’s (1) data, we found a higher frequency for gp210 (13/40 vs 13/83, p = 0.05) in our patients and similar results to theirs for other specificities. We found that sp100 positive patients had higher IgG levels than those with negative sp100; at variance with the Bologna series we found no association between gp210 antibody seropositivity and clinical, histological, and biochemical parameters (Table 1). The regional difference in gp210 autoantibody prevalence between Spanish and Italian patients is reminiscent of the difference in AMA prevalence between North American and Japanese PBC patients; more than 95% of Americans react with pyruvate dehydrogenase complex-E2 and less than 65% of Japanese do so (2). These differences may be equally due to different environments (3) or different genetic backgrounds.