RESUMEN
AIMS: To determine the frequency of anti-cardiolipin (aCL) and anti-ß2-glycoprotein I antibodies (aß2GPI) in celiac disease (CD) patients. PATIENTS AND METHODS: Sixty-three untreated CD patients and 40 healthy blood donors (HBD) were studied. IgG, IgA and IgM aCL and aß2GPI were detected by Elisa. RESULTS: The frequency of antiphospholipid antibodies (aPL) (aCL and/or aß2GPI) was significantly higher in CD patients (12 out of 63) than in HBD (two out of 40) (19% vs 5%, P=0.04). Six CD patients out of 63 (9.5%) and one HBD out of 40 (2.5%) had aCL. Ten CD patients (15.9%) and two HBD (5%) had aß2GPI. Only aß2GPI-IgA was significantly more frequent in CD patients than in HBD (14.3% vs 2.5%, P=0.048). In CD patients, aß2GPI-IgA (nine out of 63) was significantly more frequent (14.3%) than aß2GPI-IgG (1.6%) and IgM (1.6%) (P=0.008). In CD patients, the frequency of aCL-IgA and IgM was 6.3% (four out of 63) and aCL-IgG were not detected. Simultaneous presence of positive antibodies was found in four CD patients: one patient had four aPL, one had three aPL and two had two aPL. The four patients who had aCL-IgA had also aß2GPI-IgA and three of them had a titer higher than 50 units. Among nine patients with aß2GPI-IgA, four had a titer higher than 100 units. The highest titers were found in adults. CONCLUSIONS: aPL and particularly aß2GPI-IgA are frequent in CD. The significance of these antibodies has to be determined.
Asunto(s)
Anticuerpos Anticardiolipina/sangre , Anticuerpos/sangre , Enfermedad Celíaca/sangre , Enfermedad Celíaca/epidemiología , beta 2 Glicoproteína I/inmunología , Adolescente , Adulto , Anciano , Anticuerpos/análisis , Anticuerpos Antifosfolípidos/sangre , Cardiolipinas/inmunología , Estudios de Casos y Controles , Enfermedad Celíaca/inmunología , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , Adulto JovenRESUMEN
AIMS: The purpose of this study was to determine the sensitivity and specificity of IgA anti-actin antibodies (IgA-AAA) for celiac disease (CD), to investigate their usefulness as a marker of compliance in CD patients to the gluten-free diet (GFD), and to assess the relationship between their presence in the sera of CD patients and severity of intestinal mucosal damage. PATIENTS AND METHODS: A total of 182 patients with CD were studied: 63 patients were untreated; 50 patients were following a strict GFD; and 69 patients were non-compliant with a GFD. IgA-AAA was detected using a homemade enzyme-linked immunosorbent assay (ELISA). RESULTS: IgA-AAA showed a sensitivity of 41.3% and a specificity of 71.4% for a diagnosis of CD. In children, the frequency of IgA-AAA detection was lower in those following a strict GFD (23.1%) compared with untreated patients (39.4%) and those not complying with a GFD (32.5%). In patients following a strict GFD, IgA-AAA detection was significantly less frequent in children than in adults (23.1% vs. 58.3%, respectively; P<0.001). IgA-AAA was found in 17 out of 52 CD patients with total villous atrophy (32.7%), and in one out of 11 patients with subtotal villous atrophy (9%). CONCLUSION: IgA-AAA cannot replace anti-endomysium and anti-tissue transglutaminase antibodies in the diagnosis algorithm of CD, but it can serve as a reliable marker of severe intestinal mucosal damage in CD patients.