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Small intestinal disease
Immune reaction against the cytoskeleton in coeliac disease
  1. M G Clementea,
  2. M P Musua,
  3. F Fraua,
  4. G Bruscob,
  5. G Solec,
  6. G R Corazzab,
  7. S De Virgiliisa
  1. aDipartimento di Scienze Biomediche e Biotecnologie, Servizio delle Malattie Metaboliche del Bambino, Università degli Studi di Cagliari, Cagliari, Italy, bIRCCS Policlinico “S Matteo”, Divisione di Gastroenterologia, Università degli Studi di Pavia, Pavia, Italy, cIstituto di Ricerca sulle Talassemie ed Anemie Mediterranee, Consiglio Nazionale delle Ricerche, Cagliari, Italy
  1. Professor S De Virgiliis, Servizio delle Malattie Metaboliche del Bambino, Centro Regionale per le Microcitemie, via Jenner, 09121, Cagliari, Italy. Email: sdevirgi{at}mcweb.unica.it

Abstract

BACKGROUND The cytoskeleton actin network of intestinal microvilli has been found to be rapidly impaired after gluten challenge in coeliac disease (CD). The aim of this study was to investigate the presence of an immune reaction towards cytoskeleton structures such as actin filaments in CD.

METHODS Eighty three antiendomysial antibody positive CD patients (52 children and 31 adults) were studied at our outpatient clinics from 1996 to 1998 using indirect immunofluorescence, ELISA, and western blotting for antiactin (AAA) and antitissue transglutaminase (TGA) antibodies before and after a gluten free diet (GFD). Sixteen patients with smooth muscle antibody positive autoimmune hepatitis, 21 with inflammatory bowel diseases, seven with small bowel bacterial overgrowth, and 60 healthy subjects were studied as controls.

RESULTS Fifty nine of 83 CD patients (28/31 adults (90.3%); 31/52 children (59.6%)) were positive for IgA and/or IgG AAA. Seventy seven (92.7%) were positive for IgA TGA. IgA AAA were strongly correlated with more severe degrees of intestinal villous atrophy (p<0.0001; relative risk 86.17). After a GFD, AAA became undetectable within five months.

CONCLUSIONS Apart from the immune reaction against the extracellular matrix, we have described an immune reaction against the cytoskeleton in both children and adults with CD. As AAA are strongly associated with more severe degrees of villous atrophy, they may represent a useful serological marker of severe intestinal atrophy in CD.

  • coeliac disease
  • autoantibody
  • intestinal villous atrophy
  • cytoskeleton
  • actin
  • smooth muscle

  • Abbreviations used in this paper

    AAA
    antiactin antibodies
    GFD
    gluten free diet
    AEA
    antiendomysium antibodies
    AGA
    antigliadin antibodies
    AH
    autoimmune hepatitis
    IBD
    inflammatory bowel disease
    AMA
    antimitochondrial antibodies
    IF
    indirect immunofluorescence
    ANA
    antinuclear antibodies
    ANCA
    antineutrophil cytoplasm antibodies
    ARA
    antireticulin antibodies
    CD
    coeliac disease
    LC-1
    antiliver cytosol 1 antibodies
    LKM
    antiliver kidney microsome antibodies
    SMA
    smooth muscle antibodies
    PBS
    phosphate buffered saline
    SLA
    antisoluble liver antigen antibodies
    TGA
    antitransglutaminase antibodies
    tTG
    tissue transglutaminase
    RR
    relative risk

    • https://doi.org/10.1136/gut.47.4.520

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    • Abbreviations used in this paper

      AAA
      antiactin antibodies
      GFD
      gluten free diet
      AEA
      antiendomysium antibodies
      AGA
      antigliadin antibodies
      AH
      autoimmune hepatitis
      IBD
      inflammatory bowel disease
      AMA
      antimitochondrial antibodies
      IF
      indirect immunofluorescence
      ANA
      antinuclear antibodies
      ANCA
      antineutrophil cytoplasm antibodies
      ARA
      antireticulin antibodies
      CD
      coeliac disease
      LC-1
      antiliver cytosol 1 antibodies
      LKM
      antiliver kidney microsome antibodies
      SMA
      smooth muscle antibodies
      PBS
      phosphate buffered saline
      SLA
      antisoluble liver antigen antibodies
      TGA
      antitransglutaminase antibodies
      tTG
      tissue transglutaminase
      RR
      relative risk
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