Enzyme immunoassay for autoantibodies to human liver-type arginase and its clinical application.

BACKGROUND Arginase is an enzyme of the urea cycle, and one of the two isoenzymes is the liver-type enzyme. We examined serum autoantibodies to this liver-type enzyme in patients with hepatitis. METHODS Antibodies to recombinant human liver-type arginase were measured by ELISA in 95 patients and 55 healthy controls. RESULTS The mean absorbance values in the ELISA assays of patients with definite autoimmune hepatitis (n = 11; P <0.0001), probable autoimmune hepatitis (n = 31; P <0.0001), and hepatitis C (HCV; n = 20; P <0.01) were significantly different from those of healthy controls, but the values in patients with hepatitis B (HBV; n = 23) and other autoimmune diseases (n = 10) were not significantly different from those of healthy controls. When the cutoff was fixed at the upper 95th percentile of the absorbance value in healthy controls, positive reactions were found in 18.2%, 32.3%, 20.0%, 13. 0%, and 10.0% of patients with definite autoimmune hepatitis, probable autoimmune hepatitis, HCV hepatitis, HBV hepatitis, and other autoimmune diseases, respectively. All of these positive reactions were abolished by inhibition of serum with recombinant antigen. The specificity and sensitivity of this ELISA were 96% and 29%, respectively. The intraassay and interassay coefficients of variation were 2.3-7.5% and 9.8-11%, respectively. There was no relationship between these antibodies and anti-nuclear, anti-smooth muscle, or anti-cytochrome P450IID6 antibodies. CONCLUSIONS The ELISA for anti-liver-type arginase autoantibody improved the detectability of autoimmune hepatitis when compared with established assays for liver-specific autoantibodies.