Serum anti-integrin αvβ6 autoantibodies for diagnosis of primary sclerosing cholangitis: a systematic review and meta-analysis

Stavros P. Papadakos; Stamatina Vogli; Alexandra D. Argyrou; Antonios Chatzigeorgiou; Andreas Koutsoumpas; Jiannis Vlachogiannakos; George V. Papatheodoridis

Authors Stavros P. Papadakos, Stamatina Vogli, Alexandra D. Argyrou, Antonios Chatzigeorgiou, Prof., Andreas Koutsoumpas, Jiannis Vlachogiannakos, George V. Papatheodoridis.

Abstract

Background Currently, there is no noninvasive serological marker for primary sclerosing cholangitis (PSC). Serum anti-integrin αvβ6 autoantibodies were recently suggested as potential diagnostic PSC biomarkers. We conducted a systematic review and meta-analysis to evaluate their diagnostic performance, the influence of concomitant inflammatory bowel disease (IBD), and differentiation from other cholestatic liver diseases.

Methods PubMed, Embase, Cochrane Library and Web of Science databases were systematically searched for studies assessing the diagnostic value of serum anti-αvβ6 autoantibodies in PSC. Pooled sensitivity, specificity, diagnostic odds ratio and area under the summary receiver operating characteristic curve (AUC) were calculated using a bivariate random-effects model. Subgroup analyses were performed based on IBD status and differentiation from other cholestatic liver diseases.

Results Four studies including 1294 subjects (398 PSC patients and 896 controls) were analyzed. The pooled sensitivity and specificity of anti-αvβ6 autoantibodies for PSC diagnosis were 62.3% and 87.3%, respectively (AUC: 0.76). The specificity increased to 96% (AUC: 0.86) in PSC without IBD, while it decreased to 71% (AUC: 0.67) in PSC with IBD. For the differentiation of PSC from other cholestatic liver diseases, anti-αvβ6 autoantibodies had pooled sensitivity 81% and specificity 95% (AUC: 0.90).

Conclusions Serum anti-αvβ6 autoantibodies exhibit moderate sensitivity and high specificity for PSC diagnosis, especially in differentiation from other cholestatic diseases. Their clinical utility as a noninvasive diagnostic biomarker is promising and warrants validation in larger, multicenter prospective studies to establish their role in routine clinical practice.

Keywords Primary sclerosing cholangitis, anti-integrin αvβ6 autoantibodies, diagnostic biomarker, inflammatory bowel disease

Ann Gastroenterol 2026; 39 (1): 40-47