In vitro production of endomysial antibodies in cultured duodenal mucosa from patients with celiac disease.
OBJECTIVE
Endomysial antibodies (EMAs) had been found recently after in vitro gluten challenge of duodenal mucosa from treated celiac patients. This was a promising result for diagnosis of potential/latent celiac disease. Therefore, we tested the usefulness of the production of EMAs of in vitro-challenged mucosa for diagnosis of celiac disease and determined the location of EMA production.


METHODS
We investigated EMAs in the serum, in the supernatants of in vitro gliadin-challenged duodenal mucosa specimens in 68 patients, and in homogenized native duodenal and gastric specimens in seven patients. Twenty-one of the 68 patients served as nonceliac controls, 11 as candidates for potential celiac disease, 23 celiac patients were on glutenfree diet, and 13 were newly diagnosed.


RESULTS
EMAs were just found in the supernatants of duodenal biopsies of those celiac patients who had demonstrable EMAs in serum, independent of gliadin challenge. In these patients EMAs were also found in homogenized native duodenal biopsies, but not in gastric biopsies.


CONCLUSIONS
EMAs seem to be produced in the small bowel mucosa of celiac patients, but not in other tissues such as gastric mucosa. The production of EMAs could not be initiated under standard in vitro conditions and therefore, such as in vitro challenge cannot be used for diagnostic purposes.
Vogelsang
H
H
Department of Gastroenterology and Hepatology, University Clinic of Internal Medicine IV, Vienna, Austria.
Schwarzenhofer
M
M
Granditsch
G
G
Oberhuber
G
G
D000328:Adult; D000917:Antibody Formation; D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000276:immunology*; D046508:Culture Techniques; D004386:Duodenum / Q000276:immunology*; D005260:Female; D005753:Gastric Mucosa / Q000276:immunology; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000096:biosynthesis; D007413:Intestinal Mucosa / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009210:Myofibrils / Q000276:immunology
D007070:Immunoglobulin A; D005903:Gliadin