Immune Reaction Against Cytoskeleton in Coeliac Disease

Clemente, Maria Grazia; Frau, Franco; Brusco, G.; Sole, Gabriella; Sannia, Andrea; Corazza, G.R.; Virgiliis, Stefano De

doi:10.1097/00005176-199905000-00050

Cited by 25 publications

(42 citation statements)

References 24 publications

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“…However, these serological tests do not correlate with histopathological features [8,18] and only recently another test -the AAA assay -has been proposed as a marker of the severity of intestinal mucosa damage in CD [9,10].…”

Section: Discussionmentioning

confidence: 99%

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IgA anti-actin antibodies ELISA in coeliac disease: A multicentre study

Carroccio

Brusca

Iacono

et al. 2007

Digestive and Liver Disease

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Background. Previous studies have demonstrated that serum anti-actin antibodies are a reliable marker of intestinal damage severity in coeliac disease.Aims. To validate in a multicentre study the clinical usefulness of serum IgA anti-actin antibody ELISA and its possible use in monitoring intestinal mucosa lesions during gluten-free diet.Patients and methods. Four centres recruited 205 newly diagnosed coeliac disease patients with villous atrophy, 80 healthy controls and 81 "disease" controls. Twelve coeliac disease patients on gluten-free diet but with persistent symptoms underwent serum IgA anti-actin antibody assay and intestinal histology evaluation. IgA anti-actin antibody ELISA was performed with a commercial kit. All coeliac disease patients underwent intestinal histology study.Results. IgA anti-actin antibodies showed a sensitivity of 80% and a specificity of 85% in the diagnosis of coeliac disease patients with villous atrophy. The area under the receiving operator curve for anti-actin antibodies was 0.873 [95% C.I. 0.805-0.899]. Serum anti-actin antibodies values were significantly higher in coeliac disease patients than in healthy or "disease" controls (P < 0.0001). Serum anti-actin antibodies were positive in 41 of the 60 coeliac disease patients with mild intestinal histology lesions (69%) and in 123 of the 145 with severe lesions (85.3%) (P < 0.05). There was a significant inverse correlation between anti-actin antibody values and the villi/crypts ratio (r = −0.423; P < 0.0001). In the 12 coeliac disease patients on gluten-free diet who underwent re-evaluation as they were persistently symptomatic, intestinal histology showed three cases with persistent villous atrophy: all of these were positive for serum anti-actin antibodies ELISA, whereas both serum anti-tTG and EmAs were negative. The other nine patients showed normal intestinal villi and were negative for serum anti-actin antibodies.Conclusions. Anti-actin antibodies are a reliable marker of severe intestinal mucosa damage in coeliac disease patients and a simple ELISA technique offers an accurate method for their determination. These antibodies seem to be a very reliable marker of persistent intestinal damage in coeliac disease patients.

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Section: Discussionmentioning

confidence: 99%

“…However, these assays do not reflect the severity of the intestinal mucosa damage [7,8]. In this respect, the immunofluorescence (IF) assay of IgA anti-actin antibodies (AAA) has been suggested as a useful method [9,10] and we recently described an ELISA which demonstrated to be an accurate assay for their determination [11].…”

Section: Introductionmentioning

confidence: 99%

IgA anti-actin antibodies ELISA in coeliac disease: A multicentre study

Carroccio

Brusca

Iacono

et al. 2007

Digestive and Liver Disease

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“…Presence of EMA or tTGA in our study was significantly associated with more severe villous atrophy. Sensitivity of serological testing is questionable among patients presenting with PVA, thus reducing its effectiveness in clinical practice [12,18,19,22]. Rostami et al [23] show that EMA has a lower sensitivity in CD patients with milder intestinal damage.…”

Section: Discussionmentioning

confidence: 99%

“…Fewer data correlating serologic levels with degree of villous atrophy are available. Clemente et al [12] found IgA antibodies against actin filaments (AAA) in 60% of children and 90% of adults with severe or moderate villous atrophy caused by CD. In their study, IgA AAA were strongly correlated with more severe degrees of intestinal villous atrophy.…”

Section: Introductionmentioning

confidence: 99%

Serology in adults with celiac disease: limited accuracy in patients with mild histological lesions

et al. 2011

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Celiac disease (CD) is a gluten-triggered enteropathy, presenting with insidious clinical patterns. It can occasionally be diagnosed in asymptomatic subjects. Our aim was to define the relationship among symptoms at diagnosis, serological markers [tissue transglutaminase antibodies (tTGA), anti-endomysium antibodies (EMA) anti-actin antibodies (AAA)] and degree of mucosal damage. A total of 68 consecutive adult patients with CD were enrolled. Intestinal biopsies were scored according to the Marsh classification modified by Oberhuber: I-II minimal lesions or absent villous atrophy; IIIA partial villous atrophy; IIIB-C total villous atrophy (TVA). HLA-typing was done for all patients. No association between clinical presentation and severity of mucosal damage was found. Presence of EMA or tTGA was significantly associated with more severe mucosal damage (P \ 0.001). Of 12 patients, 11 with AAA were also positive for TVA. The severity of mucosal damage is the main factor governing the detectability of serological markers of CD. The sensitivity of serological testing is questionable in patients with minimal lesions.

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“…Clinically, this injury results in diarrhea and in malabsorption. The gliadin-induced molecular mechanisms are not yet clarified (7)(8)(9).…”

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confidence: 99%