Anti-tissue transglutaminase antibodies in inflammatory bowel disease: new evidence.
Anti-tissue transglutaminase, previously held to be identical to anti-endomysial antibodies in celiac sprue, has been reported in inflammatory bowel disease patients. To investigate these data further, we evaluated serum and intestinal anti-tissue transglutaminase in inflammatory bowel disease patients, with respect to the Crohn's disease activity index and the integrated disease activity index. Study population comprised: 49 patients with Crohn's disease and 29 patients with ulcerative colitis; 45 patients with celiac sprue and 85 autoimmune patients as disease controls; and 58 volunteers as healthy controls. Immunoglobulin A (IgA) anti-recombinant human tissue transglutaminase and anti-endomysial antibody detection in sera and fecal supernatants were performed. Adsorption of positive sera with recombinant human tissue transglutaminase were also performed. Marked increased anti-tissue transglutaminase concentrations were found in celiac sprue, while low-positive values were also found in Crohn's disease and ulcerative colitis. Anti-endomysial antibodies were detectable only in celiac sprue. Antigen adsorption resulted in a significant reduction of the anti-tissue transglutaminase either in celiac sprue or inflammatory bowel disease sera. A significant correlation between anti-tissue transglutaminase and Crohn's disease activity index or integrated disease activity index scores was found. Anti-tissue transglutaminase was also detectable in fecal supernatants from inflammatory bowel disease patients. Data highlight that both circulating and intestinal anti-tissue transglutaminases are detectable in inflammatory bowel disease, and that they are related to disease activity. These features underline that, in addition to anti-tissue transglutaminase, an anti-endomysial antibody test is necessary in the diagnostic work-up of celiac sprue, especially in patients with known inflammatory bowel disease.
Di Tola
Marco
M
Department of Clinical Sciences, University La Sapienza, Rome, Italy.
Sabbatella
Luigi
L
Anania
Maria Cristina
MC
Viscido
Angelo
A
Caprilli
Renzo
R
Pica
Roberta
R
Paoluzi
Paolo
P
Picarelli
Antonio
A
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D001327:Autoimmune Diseases / Q000276:immunology; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology; D003424:Crohn Disease / Q000175:diagnosis / Q000276:immunology; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D015212:Inflammatory Bowel Diseases / Q000276:immunology* / Q000378:metabolism; D044967:Serum / Q000737:chemistry; D012720:Severity of Illness Index; D011503:Transglutaminases / Q000276:immunology* / Q000378:metabolism
D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D011503:Transglutaminases