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Anti-mitochondrial M2-3E IgG (AMA-M2-3E IgG)

Known as: anti-mitochondrial M2-3E IgG antibodies
SKU: 1508

160.00

Study material: Venous blood
Response time (working day): 14
The test is done on an empty stomach: no
Home call service: Yes
Country: EU

General Information

Anti-mitochondrial antibodies (AMA) are organ-nonspecific antibodies directed against lipoproteins in the inner membrane of mitochondria.

Anti-mitochondrial antibodies (AMA) are a serological marker for primary biliary cirrhosis (prevalence 90–96%).

Primary biliary cirrhosis is a chronic autoimmune liver disease that causes progressive damage to the small bile ducts.

The developed immune response damages the epithelial cells of the ducts (with antibodies produced against the mitochondrial structures of the epithelial cells).

Clinically, cholestasis (stagnation of bile), hepatitis (inflammation of liver tissue), and fibrotic (connective tissue) degeneration develop – ultimately leading to cirrhosis.

The disease occurs mostly in women and has a genetic predisposition.

Mitochondrial antigens, which are recognized by anti-mitochondrial antibodies (AMA), are divided into 9 subtypes (M1–M9), with M2 being the subtype most associated with primary biliary cirrhosis (99% of patients).

The classes of antimitochondrial antigens are:

  • M1 – Cardiolipin (phospholipid)
  • M2 – Pyruvate dehydrogenase complex (the most important and specific for primary biliary cirrhosis)
  • M3 – Components of the outer mitochondrial membrane
  • M4 – Sulfitoxidase
  • M5 – Various mitochondrial proteins (less defined)
  • M6 – Mitochondrial enzyme components
  • M7 – Sarcosine oxidase
  • M8 – Dihydrolipoamide dehydrogenase-related antigens
  • M9 – Glycogen phosphorylase

Especially important M2, because it is found in almost all cases (≈95–99%) of primary biliary cirrhosis and is an important diagnostic marker.

 

 

 

Patient preparation

The study is conducted both fasting and after meals.

Study material: Venous blood

Method: ELISA

The study identifies antimitochondrial IgG antibodies

 

Referral norm: Negative

Normally, antibodies to mitochondrial antigens are negative. A positive indicator of the study is most often associated with primary biliary cirrhosis, lupus, rheumatoid arthritis, certain types of cardiomyopathies, etc.

In case of positive research results, it may be necessary to conduct additional studies to confirm the diagnostics.

 

 

 

 

When should we take the test?

  • Primary biliary cirrhosis (PBC)
    • The most important and specific indicator is
    • Positive in ~90–96% of patients
    • especially M2 subtype Is diagnostically valuable

Other conditions where AMA may be present (less specific)

  • აუტოიმუნური ჰეპატიტი
  • Chronic active hepatitis
  • Cryptogenic cirrhosis
  • Other autoimmune diseases (rare)

 

Possible interpretation of the results

An ambiguous response from the study requires a repeat test in 2-3 weeks.

A small number of patients with biliary cirrhosis may not have antimitochondrial antibodies (AMA) detected.

 

Antimitochondrial antibodies (AMA) may sometimes be detected in other liver diseases:

    • Chronic active hepatitis
    • Cryptogenic cirrhosis
    • Patients with clinical signs of liver disease without biochemical changes

 

Antimitochondrial antibodies (AMA) can sometimes be detected in other pathologies:

    • Systemic lupus erythematosus (SLE)
    • Rheumatoid arthritis
    • Thyroid diseases
    • Pernicious anemia
    • Addison's disease

Reference values

 AMA-M2 antibodies

  • Directed against the pyruvate dehydrogenase complex (especially PDC-E2)

Main use: To confirm the diagnostics of primary biliary cholangitis

The most important and specific marker (~95–99%) is

AMA-M2-3E antibodies

  • Includes 3 main antigens: PDC-E2, BCOADC-E2, OGDC-E2

Usage: To confirm the diagnostics of primary biliary cholangitis. More sensitive marker in early stages

Used: when M2 is doubtful or negative, but the clinic is consistent

AMA-M4 antibodies

  • Associated with sulfite oxidase (an enzyme involved in the metabolism of sulfur-containing amino acids.

Usage: Primary biliary cholangitis + autoimmune hepatitis (overlap syndrome)

  •  Indicates more of the disease On a mixed (overlap) form

AMA-M7 antibodies

  • Associated with sarcosine oxidase (a mitochondrial enzyme involved in the metabolism of amino acids, especially glycine)

Usage: Diagnosis of autoimmune inflammatory processes (rarely)

AMA-M9 antibodies

  • Less aggressive/early mitochondrial antigen-related

Usage: In the early stages of primary biliary cholangitis

(sometimes precedes the development of M2 antibodies)

Associated with a milder course

 Brief summary

  • M2 / M2-3E → Main diagnostic markers (PBC)
  • M4 → overlap syndrome (PBC + autoimmune hepatitis)
  • M7 → Low specificity, rare use
  • M9 → Early/mild forms

Testing process

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