title: Elevated serum anti-Saccharomyces cerevisiae, anti-I2 and anti-OmpW antibody levels in patients with suspicion of celiac disease.
abstract: 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.
authors.affiliation: Paediatric Research Centre and Medical School, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Sara
authors.initials: S
authors.lastname: Ashorn
authors.forename: Hanna
authors.initials: H
authors.lastname: Raukola
authors.forename: Tuuli
authors.initials: T
authors.lastname: Välineva
authors.forename: Merja
authors.initials: M
authors.lastname: Ashorn
authors.forename: Bo
authors.initials: B
authors.lastname: Wei
authors.forename: Jonathan
authors.initials: J
authors.lastname: Braun
authors.forename: Immo
authors.initials: I
authors.lastname: Rantala
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.forename: Sari
authors.initials: S
authors.lastname: Iltanen
mesh_terms: 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
chemical_list: D000910:Antibodies, Heterophile; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D015415:Biomarkers; C437325:OmpW protein, Bacteroides caccae; D029701:Saccharomyces cerevisiae Proteins