Elevated serum anti-Saccharomyces cerevisiae, anti-I2 and anti-OmpW antibody levels in patients with suspicion of celiac disease.
OBJECTIVE
Expression of anti-Saccharomyces cerevisiae antibodies (ASCA) identifies patients and individuals at risk for Crohn's disease and has also been reported in 40-60% of celiac disease (CD) cases, suggesting a role of host response to enteric microbiota in the development of inflammatory lesions. In this prospective study in patients with suspicion of CD, we evaluate the frequency and association of ASCA to serological responses for other host microbial targets formally associated with Crohn's disease, including the Pseudomonas fluorescens associated sequence I2 and a Bacteroides caccae TonB-linked outer membrane protein, OmpW.


METHODS
Small bowel mucosal biopsies were taken from 242 patients with suspicion of CD, their sera were tested for antibodies to tissue transglutaminase (tTG), ASCA, I2, and OmpW. Eighty adult healthy blood donors were used as controls.


RESULTS
The diagnosis of CD was confirmed on biopsy in 134 cases. The occurrence of ASCA and I2 positivity was significantly higher in adult CD patients than in patients with non-CD disease. Anti-I2 levels in the sera were significantly higher in adult CD patients than in non-CD disease or the controls and anti-OmpW levels in CD and non-CD patients when compared to controls. Positive seroreactivity to OmpW seemed to increase with age. Of the CD patients, 90% were seropositive for at least one microbial antigen tested.


CONCLUSIONS
This study demonstrates a mosaic of disease-related serological responses to microbial antigens in patients with CD. Immune responses to commensal enteric bacteria may play a role in the small intestine mucosal damage in CD.
Ashorn
Sara
S
Paediatric Research Centre and Medical School, University of Tampere and Tampere University Hospital, Tampere, Finland.
Raukola
Hanna
H
Välineva
Tuuli
T
Ashorn
Merja
M
Wei
Bo
B
Braun
Jonathan
J
Rantala
Immo
I
Kaukinen
Katri
K
Luukkaala
Tiina
T
Collin
Pekka
P
Mäki
Markku
M
Iltanen
Sari
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000910:Antibodies, Heterophile / Q000097:blood*; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology / Q000378:metabolism*; D001426:Bacterial Proteins / Q000276:immunology / Q000378:metabolism; D015415:Biomarkers; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011551:Pseudomonas fluorescens / Q000276:immunology; D012441:Saccharomyces cerevisiae / Q000276:immunology*; D029701:Saccharomyces cerevisiae Proteins / Q000276:immunology / Q000378:metabolism*; D012698:Serologic Tests
D000910:Antibodies, Heterophile; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D015415:Biomarkers; C437325:OmpW protein, Bacteroides caccae; D029701:Saccharomyces cerevisiae Proteins