{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T01:29:26Z","timestamp":1779931766339,"version":"3.53.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2003,12,16]],"date-time":"2003-12-16T00:00:00Z","timestamp":1071532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,12,16]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Anti-mitochondrial antibody (AMA) is considered the serological hallmark of primary biliary cirrhosis (PBC), but may be missing in a proportion of these patients. We assessed sensitivity and specificity of the currently available techniques for AMA detection in a large series of PBC patients and controls, and analysed their clinical and immunological features according to the AMA status. By indirect immunofluorescence on rat tissue sections and HEp-2 cells, Western immunoblot with bovine submitochondrial particles, and two ELISAs with AMA-specific recombinant proteins, we evaluated the presence of AMA in 127 PBC patients, 166 patients with type 1 autoimmune hepatitis and 100 with non alcoholic fatty liver disease. In PBC patients Western immunoblot detects AMA significantly more often than indirect immunofluorescence on HEp-2 cells (85%versus 72%,\u2003P\u2003= 0\u00b702) or rodent tissue sections (71%,\u2003P\u2003= 0\u00b701); both ELISAs are only slightly less sensitive than Western immunoblot (81% and 78%). Ten patients with non alcoholic fatty liver disease were AMA-positive by indirect immunofluorescence, but none recognized AMA-specific epitopes in Western immunoblot or in ELISAs. Twelve patients with type 1 autoimmune hepatitis were AMA-positive by indirect immunofluorescence, but only 6 (3\u00b76%) reacted by Western immunoblot and ELISAs. Western immunoblot or ELISA should be regarded as first-line assay for the detection of AMA. Up to 15% of PBC patients are consistently AMA-negative, yet they share the same clinical, biochemical and histological features of AMA-positive PBC. Detection of AMA in type 1 autoimmune hepatitis might identify a subset of patients at risk of developing a hepatitic\/cholestatic syndrome.<\/jats:p>","DOI":"10.1111\/j.1365-2249.2004.02332.x","type":"journal-article","created":{"date-parts":[[2003,12,16]],"date-time":"2003-12-16T16:38:20Z","timestamp":1071592700000},"page":"154-158","source":"Crossref","is-referenced-by-count":75,"title":["\u2018True\u2019 antimitochondrial antibody-negative primary biliary cirrhosis, low sensitivity of the routine assays, or both?"],"prefix":"10.1093","volume":"135","author":[{"given":"P","family":"MURATORI","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"MURATORI","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M E","family":"GERSHWIN","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Clinical Immunology University of California at Davis, Davis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J","family":"CZAJA","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"PAPPAS","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"MACCARIELLO","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"GRANITO","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"CASSANI","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"LORIA","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Gastroenterology, University of Modena, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"LENZI","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F B","family":"BIANCHI","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardioangiology, Hepatology, Alma Mater Studiorum \u2013 University of Bologna, Bologna"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2003,12,16]]},"reference":[{"key":"2022011223173055000_b1","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1056\/NEJM199611213352107","article-title":"Primary biliary cirrhosis","volume":"335","author":"Kaplan","year":"1996","journal-title":"N Engl J Med"},{"key":"2022011223173055000_b2","first-page":"237","article-title":"Tissue antibodies in primary biliary cirrhosis, active chronic (lupoid) hepatitis, cryptogenic cirrhosis and other liver diseases and their clinical implications","volume":"1","author":"Doniach","year":"1966","journal-title":"Clin Exp 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