Familial Expression of Serological Immune Responses in Pediatric Ibd

Abstract

Background: Although IgA endomysial antibodies (EMA) and tissue transglutaminase (TG) are sensitive and specific serologic tests for the diagnosis of celiac disease, there is limited information on the association of the magnitude of antibody level with the severity of the histological abnormalities of the intestine. Purpose: To determine if EMA and TG titers correlate with the severity of histological changes in patients with celiac disease. Methods: We identified 148 children from our laboratory database that had EMA, TG and intestinal biopsies performed. IgA EMA was determined by indirect immunofluorescence with results expressed as a dilutional titer with positivity determined at 1:5. IgA TG was determined by an enzyme linked human immunosorbent ELISA assay with results expressed in standardized units. A modified Marsh histological grading system was used to describe the duodenal biopsies: Type 0 normal, I increased intraepithelial lymphocytes (IEL), II hyperplastic crypts, IIIa partial villus atrophy, IIIb subtotal villus atrophy, IIIc total villous atrophy. Results: Mean values for EMA (Table 1) and TG (Table 2) progressively increased with increasing Marsh score. Conclusion:There was considerable variability in EMA and TG levels for each Marsh grade, so that an individual level could not be utilized to predict histological severity. The data show that as a group, increasing severity of the histological lesion in celiac disease was associated with increased levels of both IgA EMA and TG antibodies.

What Is the Role of Serological Markers in IBD? Pediatric and Adult Data

“…A very recent study has shown that antibodies to OmpC have a strong familial aggregation pattern [62] . Preliminary studies in a pediatric cohort suggest that the quantitative but more so the qualitative expression of immune responses to microbial antigens is increased in the parents of pediatric CD patients, suggesting that the immune dysregulation observed in such patients is a familial trait [63] . Further research in a larger number of parents will increase our understanding of the role of familial expression of serological immune response.…”