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Anti-smooth muscle antibodies are antibodies (immunoglobulins) formed against smooth muscle. These antibodies are typically associated with autoimmune hepatitis. [1] [2] These antibodies can be directed against actin, troponin, and tropomyosin. [3]
A number of specific antibodies found in the blood (antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), anti-liver kidney microsomal antibodies (LKM-1, LKM-2, LKM-3), anti soluble liver antigen (SLA), liver–pancreas antigen (LP), and anti-mitochondrial antibody (AMA)) are of use, as is finding an increased immunoglobulin G level.
Anti-mitochondrial antibodies (AMA) are autoantibodies, consisting of immunoglobulins formed against mitochondria, [1] primarily the mitochondria in cells of the liver.. The presence of AMA in the blood or serum of a person may be indicative of the presence of, or the potential to develop, the autoimmune disease primary biliary cholangitis (PBC; previously known as primary biliary cirrhosis).
Autoantibody tests may be ordered as part of an investigation of chronic progressive arthritis type symptoms and/or unexplained fevers, fatigue, muscle weakness and rashes. The antinuclear antibody (ANA) test is often ordered first. ANA is a marker of the autoimmune process – it is positive with a variety of different autoimmune diseases but ...
Antinuclear antibodies and anti-smooth muscle antibody are found in 20–50% of PSC patients, and likewise are not specific for the disease, but may identify a subgroup of PSC patients who also have autoimmune hepatitis (i.e. PSC-AIH overlap syndrome). [4]
The exact cause is unclear. A combination of consistent findings on physical examination, the presence of anti HMG-CoA reductase antibodies in a person with myopathy, evidence of muscle breakdown, and muscle biopsy diagnose SAAM. [3] Treatment involves stopping the associated statin medication and taking medication to suppress the immune system.
In coeliac disease, anti-actin antibody levels correlate with the level of intestinal damage. [2] [3] In autoimmune hepatitis, anti-actin antibody levels correlate with patterns of immune recognition, [4] the pattern of recognition was specific to a small percentage of autoimmune hepatitis type 1 or cryptogenic hepatitis patients. [5]
Liver kidney microsomal type 1 antibody (anti-LKM1) is an autoantibody associated with autoimmune hepatitis (AIH). [1] Specifically, its presence in AIH defines type 2 AIH, [ 2 ] [ 3 ] although it has been proposed that anti-liver cytosol type 1 autoantibody without detectable anti-LKM1 can be seen in type 2 AIH. [ 4 ]