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

Full Abstract

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.

Author information

Author/s: Papp, Maria (M); Foldi, Ildiko (I); Altorjay, Istvan (I); Palyu, Eszter (E); Udvardy, Miklos (M); Tumpek, Judit (J); Sipka, Sandor (S); Korponay-Szabo, Ilma Rita (IR); Nemes, Eva (E); Veres, Gabor (G); Dinya, Tamas (T); Tordai, Attila (A); Andrikovics, Hajnalka (H); Norman, Gary L (GL); Lakatos, Peter Laszlo (PL);

Affiliation: 2nd Department of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4032, Hungary. drpappm(-atsign-)yahoo.com

Journal and publication information

Publication Type: Journal Article

Journal: World journal of gastroenterology : WJG (World J Gastroenterol), published in China. (Language: eng)

Reference: 2009-Aug; vol 15 (issue 31) : pp 3891-900

Dates: Created 2009/08/24; Completed 2009/10/27;

PMID: 19701969, status: MEDLINE (last retrieval date: 10/27/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Anti-Infective Agents - blood; immunology
Antibodies - blood; immunology
Antibodies, Bacterial - immunology
Antibodies, Fungal - immunology
Bacterial Outer Membrane Proteins - immunology
Celiac Disease - blood; immunology; physiopathology
DNA Mutational Analysis
Diet, Gluten-Free

Diet, Gluten-Free
Female
Humans
Hungary
Male
Middle Aged
Mutation
Nod2 Signaling Adaptor Protein - genetics
Polysaccharides - immunology

Associated Chemicals: Anti-Infective Agents (0) ; Antibodies (0) ; Antibodies, Bacterial (0) ; Antibodies, Fungal (0) ; Bacterial Outer Membrane Proteins (0) ; Nod2 Signaling Adaptor Protein (0) ; Polysaccharides (0)

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