Anti-microbial antibodies in celiac disease: trick or treat?

Papp, Mária and Foldi, I. and Altorjay, István and Palyu, E. and Udvardy, Miklós and Korponay-Szabó, Ilma Rita and Nemes, Éva and Veres, Gábor and Tordai, Attila and Lakatos, Péter László (2009) Anti-microbial antibodies in celiac disease: trick or treat? WORLD JOURNAL OF GASTROENTEROLOGY, 15 (31). pp. 3891-3900. ISSN 1007-9327


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AIM: To determine the prevalence of a new set of anti-glycan and anti-outer membrane protein (anti-OMP) antibodies in a Hungarian cohort of adult Celiac disease (CD) patients. METHODS: 190 consecutive CD patients [M/F: 71/119, age:39.9 (SD:14.1) years], 100 healthy, and 48 gastrointestinal controls were tested for glycan anti-Saccharomyces cerevisiae (gASCA), anti-laminaribioside (ALCA), anti-chitobioside, anti-mannobioside, anti-OMP antibodies and major NOD2/CARD15 mutations. Thirty out of 82 CD patients enrolled at the time of diagnosis were re-evaluated for the same antibodies after longstanding gluten-free diet (GFD). RESULTS: 65.9% of the CD patients were positive for at least one of the tested antibodies at the time of the diagnosis. Except anti-OMP and ALCA, anti-microbial antibodies were exclusively seen in untreated CD; however, the overall sensitivity was low. Any glycan positivity (LR+: 3.13; 95% CI: 2.08-4.73) was associated with an increased likelihood ratio for diagnosing CD. Significant correlation was found between the levels of anti-glycan and anti-endomysial or anti-transglutaminase antibodies. Anti-glycan positivity was lost after longstanding GFD. Anti-glycan antibody titers were associated with symptoms at presentation, but not the presence of NOD2/CARD15 mutations. Patients with severe malabsorption more frequently had multiple antibodies at diagnosis (P = 0.019). CONCLUSION: The presence of anti-glycan antibodies in CD seems to be secondary to the impaired small bowel mucosa which can lead to increased antigen presentation. Furthermore, anti-glycan positivity may be considered an additional marker of CD and dietary adherence.

Item Type: Article
Uncontrolled Keywords: Polysaccharides; Nod2 Signaling Adaptor Protein; Humans; DNA Mutational Analysis; Diet, Gluten-Free; Bacterial Outer Membrane Proteins; Antibodies, Fungal; Antibodies, Bacterial; ANTIBODIES; Anti-Infective Agents; PATHOPHYSIOLOGY; nucleotide sequence; MUTATION; Middle Aged; immunology; GENETICS; BLOOD; symptomatology; small intestine mucosa; small intestine disease; Sensitivity and Specificity; mutation rate; Male; major clinical study; long term care; iron deficiency anemia; Hungary; human; gluten free diet; gastrointestinal symptom; Female; enteritis; disease severity; controlled study; ARTICLE; ANTIGEN PRESENTATION; antibody titer; Adult; polysaccharide; outer membrane protein; fungus antibody; bacterium antibody; antiinfective agent; ANTIBODY; unclassified drug; Saccharomyces cerevisiae antibody; protein glutamine gamma glutamyltransferase antibody; outer membrane protein antibody; microbial antibody; mannobioside antibody; laminaribioside antibody; Immunoglobulin G; Immunoglobulin A; glycan antibody; endomysium antibody; chitobioside antibody; caspase recruitment domain protein 15; biological marker; biological factor; Presenting symptoms; NOD2/CARD15; Glycans; GLUTEN-FREE DIET; Crohn's disease; celiac disease; Bacterial Translocation; Anti-Saccharomyces cerevisiae antibodies; Anti-outer membrane protein antibody
Subjects: R Medicine / orvostudomány > RC Internal medicine / belgyógyászat
R Medicine / orvostudomány > RJ Pediatrics / gyermekgyógyászat
Depositing User: MTMT SWORD
Date Deposited: 23 May 2014 06:50
Last Modified: 23 May 2014 06:50

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