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10.1002/hep.28568

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C5017301!5017301!27015613
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suck abstract from ncbi


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pmid27015613      Hepatology 2016 ; 64 (2): 501-7
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  • Immunoglobulin G4+ B?cell receptor clones distinguish immunoglobulin G 4?related disease from primary sclerosing cholangitis and biliary/pancreatic malignancies #MMPMID27015613
  • Doorenspleet ME; Hubers LM; Culver EL; Maillette de Buy Wenniger LJ; Klarenbeek PL; Chapman RW; Baas F; van de Graaf SF; Verheij J; van Gulik TM; Barnes E; Beuers U; de Vries N
  • Hepatology 2016[Aug]; 64 (2): 501-7 PMID27015613show ga
  • Immunoglobulin G4 (IgG4)?related disease (IgG4?RD) of the biliary tree and pancreas is difficult to distinguish from sclerosing cholangitis and biliary/pancreatic malignancies (CA). An accurate noninvasive test for diagnosis and monitoring of disease activity is lacking. We demonstrate that dominant IgG4+ B?cell receptor (BCR) clones determined by next?generation sequencing accurately distinguish patients with IgG4?associated cholangitis/autoimmune pancreatitis (n = 34) from those with primary sclerosing cholangitis (n = 17) and CA (n = 17). A novel, more affordable, and widely applicable quantitative polymerase chain reaction (qPCR) protocol analyzing the IgG4/IgG RNA ratio in blood also achieves excellent diagnostic accuracy (n = 125). Moreover, this qPCR test performed better than serum IgG4 levels in sensitivity (94% vs. 86%) and specificity (99% vs. 73%) and correlates with treatment response (n = 20). Conclusions: IgG4+ BCR clones and IgG4/IgG RNA ratio markedly improve delineation, early diagnosis, and monitoring of IgG4?RD of the biliary tree and pancreas. (Hepatology 2016;64:501?507)
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