IgA anti-actin antibodies in celiac disease.
OBJECTIVE
The purpose of this study was to determine the sensitivity and specificity of IgA anti-actin antibodies (IgA-AAA) for celiac disease (CD), to investigate their usefulness as a marker of compliance in CD patients to the gluten-free diet (GFD), and to assess the relationship between their presence in the sera of CD patients and severity of intestinal mucosal damage.


METHODS
A total of 182 patients with CD were studied: 63 patients were untreated; 50 patients were following a strict GFD; and 69 patients were non-compliant with a GFD. IgA-AAA was detected using a homemade enzyme-linked immunosorbent assay (ELISA).


RESULTS
IgA-AAA showed a sensitivity of 41.3% and a specificity of 71.4% for a diagnosis of CD. In children, the frequency of IgA-AAA detection was lower in those following a strict GFD (23.1%) compared with untreated patients (39.4%) and those not complying with a GFD (32.5%). In patients following a strict GFD, IgA-AAA detection was significantly less frequent in children than in adults (23.1% vs. 58.3%, respectively; P<0.001). IgA-AAA was found in 17 out of 52 CD patients with total villous atrophy (32.7%), and in one out of 11 patients with subtotal villous atrophy (9%).


CONCLUSIONS
IgA-AAA cannot replace anti-endomysium and anti-tissue transglutaminase antibodies in the diagnosis algorithm of CD, but it can serve as a reliable marker of severe intestinal mucosal damage in CD patients.
Achour
A
A
Autoimmunity and Allergy Research Unit, Faculty of Pharmacy, Monastir, Tunisia.
Thabet
Y
Y
Sakly
W
W
Mankai
A
A
Sakly
N
N
Ayadi
A
A
Sfar
M T
MT
Amri
F
F
Harbi
A
A
Essoussi
A S
AS
Krifa
A
A
Ajmi
S
S
Ghedira
I
I
D000199:Actins / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014416:Tunisia; D055815:Young Adult
D000199:Actins; D001323:Autoantibodies; D015415:Biomarkers; D007070:Immunoglobulin A