Frequency and significance of antibodies to Saccharomyces cerevisiae in autoimmune hepatitis

Our aims were to determine the frequency of antibodies to Saccharomyces cerevisiae in autoimmune hepatitis and assess associations with concurrent mucosal diseases, genetic factors, and corticosteroid response. Seropositivity was determined by enzyme immunoassay in 385 samples obtained from 178 patients. Antibodies to Saccharomyces cerevisiae were detected in 49 patients (28%), and serum levels of immunoglobulin A were higher in seropositive patients (410 +/- 35 versus 321 +/- 20 mg/dL; P = 0.02). Individuals with and without antibodies were not otherwise distinguished by concurrent mucosal diseases, laboratory findings, or outcomes. Antibodies to tissue transglutaminase occurred more commonly in seropositive patients (16 versus 4%; P = 0.008), but this association was lost when corroborating serological criteria for celiac disease were sought. We conclude that antibodies to Saccharomyces cerevisiae are common in autoimmune hepatitis. They may be associated with non-disease-specific immune responses, but they do not define individuals with a distinctive clinical phenotype, associated mucosal diseases, or treatment outcome.