title: Gliadin immune reactivity in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate whether patients with rheumatoid arthritis (RA) have immunological or clinical evidence of gluten hypersensitivity.
  
  
  METHODS
  Antigliadin antibodies (AGA) and antireticulin antibodies (ARA) were determined in two groups of RA patients and in a control group of patients with spondylarthropathies. In the first group of 42 patients with recent-onset RA, AGA and ARA were studied longitudinally during a one-year follow up period. In the second group of 36 patients with advanced RA and various abdominal symptoms examined by upper gastrointestinal endoscopy, AGA and ARA were determined cross-sectionally.
  
  
  RESULTS
  Increased AGA (IgA or IgG) levels were found in 37% (29/78) of all RA patients compared to 12% (3/25) of controls. ARA positivity (IgG) was found in 4% (3/78) of RA patients and in none of the controls. AGA positivity was increased in patients with early RA compared to patients with advanced disease (48% vs. 25%) but the difference was not statistically significant. However, no true gluten hypersensitivity with positive AGA and ARA together with villous atrophy was observed.
  
  
  CONCLUSIONS
  Despite the increased AGA positivity found distinctively in patients with recent-onset RA, none of the RA patients showed clear evidence of coeliac disease. AGA positivity in early RA may indicate a role of the gut immune system in the initiation of RA.
authors.affiliation: Department of Rheumatology, Kivelä Hospital of Helsinki, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Paimela
authors.forename: P
authors.initials: P
authors.lastname: Kurki
authors.forename: M
authors.initials: M
authors.lastname: Leirisalo-Repo
authors.forename: H
authors.initials: H
authors.lastname: Piirainen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000276:immunology*; D003430:Cross-Sectional Studies; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012155:Reticulin / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D012155:Reticulin; D005903:Gliadin