{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:34:28Z","timestamp":1782603268440,"version":"3.54.5"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol. Commun."],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>Drug\u2010induced liver injury (DILI) sometimes presents with an autoimmune hepatitis\u2010like phenotype (AI\u2010DILI), and it is challenging to distinguish it from <jats:italic toggle=\"yes\">de novo<\/jats:italic> autoimmune hepatitis (AIH). We conducted a study to identify autoantibodies unique to AI\u2010DILI by profiling serum autoantibodies. Autoantibodies were quantified using an autoantigen array containing 94 autoantigens from four groups: AI\u2010DILI (n\u00a0=\u00a065), DILI controls (n\u00a0=\u00a067), <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH (n\u00a0=\u00a017), and healthy controls (HCs; n\u00a0=\u00a030). In 37 patients with AI\u2010DILI, samples were also collected 6 months after presentation. AI\u2010DILI and <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH had similar anti\u2010neutrophil antibody and anti\u2010smooth muscle antibody prevalence. Compared to HCs, <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH had an increase in many immunoglobulin G (IgG; 35 [46.1%]) and IgM (51 [70%]) autoantibodies, whereas AI\u2010DILI had an increase of IgM (40 [54.8%]) but not IgG autoantibodies. DILI controls had a similar IgG and IgM profile compared to HCs. Comparing <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH to AI\u2010DILI identified 18 (23.7%) elevated IgG but only one (1.4%) IgM autoantibodies, indicating the unique IgG autoantibody profile in <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH. Compared to DILI and HCs, increased IgM autoantibodies in AI\u2010DILI and <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH were common; however, AI\u2010DILI induced by different drugs showed different frequencies of IgM autoantibodies, with nitrofurantoin\u2010related AI\u2010DILI showing a higher number of increased IgM autoantibodies. AI\u2010DILI autoantibody levels at diagnosis and at 6 months showed a significant decline in 37 IgM autoantibodies. A model with highly correlated IgG and IgM was fitted into multivariate logistic regression and revealed an area under the curve of 0.87 (95% confidence interval, 0.79\u20100.95) to distinguish <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH from AI\u2010DILI. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> The unique IgG and IgM autoantibody signature appears to be a promising biomarker for distinguishing AI\u2010DILI from <jats:italic toggle=\"yes\">de novo<\/jats:italic> AIH.<\/jats:p>","DOI":"10.1002\/hep4.1582","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T05:08:20Z","timestamp":1599023300000},"page":"1651-1663","source":"Crossref","is-referenced-by-count":38,"title":["Exploratory Study of Autoantibody Profiling in Drug\u2010Induced Liver Injury with an Autoimmune Phenotype"],"prefix":"10.1097","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-640X","authenticated-orcid":false,"given":"Craig","family":"Lammert","sequence":"first","affiliation":[{"name":"Department of Medicine,Indiana University School of Medicine,Indianapolis,IN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengsong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Immunology and Internal Medicine,Genomics and Microarray Core,University of Texas Southwestern,Dallas,TX,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Immunology and Internal Medicine,Genomics and Microarray Core,University of Texas Southwestern,Dallas,TX,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indu","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Immunology and Internal Medicine,Genomics and Microarray Core,University of Texas Southwestern,Dallas,TX,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Eckert","sequence":"additional","affiliation":[{"name":"Department of Medicine,Indiana University School of Medicine,Indianapolis,IN,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan\u2010Zhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Immunology and Internal Medicine,Genomics and Microarray Core,University of Texas Southwestern,Dallas,TX,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4082-3178","authenticated-orcid":false,"given":"Naga","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Department of Medicine,Indiana University School of 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