Abstract

POMA HUANCA, PATRICIA  and  SOSA TORDOYA, LUIS FERNANDO. Evaluación de tres sustratos empleados en la prueba de inmunofluorescencia indirecta que mide anticuerpos antimitocondriales para diagnóstico de cirrosis biliar primaria. Rev.Cs.Farm. y Bioq [online]. 2013, vol.1, n.1, pp.47-58. ISSN 2310-0265.

Primary biliary cirrhosis (PBC) is a chronic inflammatory liver disease of unknown etiology characterized by the destruction of the intrahepatic bile ducts that triggers liver cirrhosis. In the present study we evaluated three commonly used substrates for mitochondrial antibodies (AMA) by indirect immunofluorescence (IIF) for the diagnosis of PBC. The substrates were evaluated: histological (mouse kidney), Hep-2 cells (epithelial cells derived from human laryngeal carcinoma) and BHK- 21 (hamster kidney fibroblasts Golden Syrian) which were compared with the results of the confirmatory test (enzyme immunoassay) commercial antigens measured M2 mitochondrial antibodies (ELISA, Trinity Biotech). We selected 25 positive sera for AMA by ELISA (index > 1.10 IU / ml). Negative controls sera were from patients who had no history of liver disease and had negative results for AMA (index < 0.90 IU/mL). Of the three substrates tested, the based on BHK -21 cell line were shown to have limited usefulness, efficiency values of 56%, sensitivity 48 %, specificity of 64 % and Kappa concordance index of 0.12 (low) meade on the results of the Standard Gold Test (ELISA -AMA). For Hep-2 was moderate agreement (Kappa = 0.6) versus the Gold standard, we obtained 100% of specificity, sensitivity = 60% and 80% of efficiency. Histological mouse kidney showed a sensitivity, specificity and efficiency of 92 %, results also showed better agreement with the ELISA method (Kappa = 0.84). Of the three methods of immunofluorescence evaluated it was determined that histological mouse kidney is the most efficient substrate and therefore could be useful as a screening test for diagnosing of CBP.

Keywords : Primary Biliary Cirrhosis (PBC); anti-mitochondrial antibodies (AMA); indirect immunofluorescence (IIF).

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