title: Anti-gliadin antibodies and small intestinal mucosal damage in dermatitis herpetiformis.
abstract: Sera from forty-six patients with dermatitis herpetiformis (DH) were examined for anti-gliadin antibodies (AGA) by the enzyme linked immunosorbent assay (ELISA) test and by a simple new immunofluorescent (IF) test. AGA were present in fifteen out of thirty-two patients taking a normal diet, but in none of the fourteen taking a gluten-free diet (GFD). The presence of circulating AGA was related to the severity of the enteropathy. AGA were present in all ten patients with a flat mucosa and in four of six with a convoluted mucosa, but in only one out of thirty patients with normal morphology of the small intestine. However, in those patients taking a normal diet and with a normal morphology of the intestine there was evidence of gluten sensitivity compared to those taking a GFD, as the intraepithelial lymphocyte count (IELC) was significantly raised in the peri-nuclear and supra-nuclear positions. The study shows that the presence of AGA in the serum is a good indication of the degree of gluten sensitivity as expressed by severe mucosal damage in patients with DH.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003874:Dermatitis Herpetiformis / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D005903:Gliadin / Q000276:immunology*; D005983:Glutens; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins / Q000276:immunology*
chemical_list: D007136:Immunoglobulins; D010940:Plant Proteins; D005983:Glutens; D005903:Gliadin