title: Autoantibodies against MHC class I polypeptide-related sequence A are associated with increased risk of concomitant autoimmune diseases in celiac patients.
abstract: BACKGROUND
  Overexpression of autologous proteins can lead to the formation of autoantibodies and autoimmune diseases. MHC class I polypeptide-related sequence A (MICA) is highly expressed in the enterocytes of patients with celiac disease, which arises in response to gluten. The aim of this study was to investigate anti-MICA antibody formation in patients with celiac disease and its association with other autoimmune processes.
  
  
  METHODS
  We tested serum samples from 383 patients with celiac disease, obtained before they took up a gluten-free diet, 428 patients with diverse autoimmune diseases, and 200 controls for anti-MICA antibodies. All samples were also tested for anti-endomysium and anti-transglutaminase antibodies.
  
  
  RESULTS
  Antibodies against MICA were detected in samples from 41.7% of patients with celiac disease but in only 3.5% of those from controls (P <0.0001) and 8.2% from patients with autoimmune disease (P <0.0001). These antibodies disappeared after the instauration of a gluten-free diet. Anti-MICA antibodies were significantly prevalent in younger patients (P <0.01). Fifty-eight patients with celiac disease (15.1%) presented a concomitant autoimmune disease. Anti-MICA-positive patients had a higher risk of autoimmune disease than MICA antibody-negative patients (P <0.0001; odds ratio = 6.11). The risk was even higher when we also controlled for age (odds ratio = 11.69). Finally, we found that the associated risk of developing additional autoimmune diseases was 16 and 10 times as high in pediatric patients and adults with anti-MICA, respectively, as in those without.
  
  
  CONCLUSIONS
  The development of anti-MICA antibodies could be related to a gluten-containing diet, and seems to be involved in the development of autoimmune diseases in patients with celiac disease, especially younger ones.
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Vázquez
authors.forename: Lourdes
authors.initials: L
authors.lastname: Mozo
authors.forename: Rebeca
authors.initials: R
authors.lastname: Alonso-Arias
authors.forename: Beatriz
authors.initials: B
authors.lastname: Suárez-Álvarez
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Vidal-Castiñeira
authors.forename: Eduardo
authors.initials: E
authors.lastname: Arranz
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.forename: Carlos
authors.initials: C
authors.lastname: Bousoño
authors.forename: Marcos
authors.initials: M
authors.lastname: López-Hoyos
authors.forename: Luís
authors.initials: L
authors.lastname: Rodrigo
authors.affiliation: Department of Immunology, Hospital Universitario Central de Asturias, Oviedo 33006, Spain. inmuno@hca.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: López-Larrea
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000097:blood* / Q000175:diagnosis* / Q000178:diet therapy; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis* / Q000178:diet therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D055050:Diet, Gluten-Free / Q000379:methods; D005260:Female; D005983:Glutens / Q000008:administration & dosage / Q000009:adverse effects; D015395:Histocompatibility Antigens Class I / Q000097:blood*; D006801:Humans; D008297:Male; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015395:Histocompatibility Antigens Class I; C099187:MHC class I-related chain A; D005983:Glutens