title: Lack of serologic evidence to link IgA nephropathy with celiac disease or immune reactivity to gluten.
abstract: IgA nephropathy is the most common form of primary glomerulonephritis worldwide. Mucosal infections and food antigens, including wheat gluten, have been proposed as potential contributing environmental factors. Increased immune reactivity to gluten and/or association with celiac disease, an autoimmune disorder triggered by ingestion of gluten, have been reported in IgA nephropathy. However, studies are inconsistent about this association. We aimed to evaluate the proposed link between IgA nephropathy and celiac disease or immune reactivity to gluten by conducting a comprehensive analysis of associated serologic markers in cohorts of well-characterized patients and controls. Study participants included patients with biopsy-proven IgA nephropathy (n = 99), unaffected controls of similar age, gender, and race (n = 96), and patients with biopsy-proven celiac disease (n = 30). All serum specimens were tested for IgG and IgA antibodies to native gliadin and deamidated gliadin, as well as IgA antibody to transglutaminase 2 (TG2). Anti-TG2 antibody-positive nephropathy patients and unaffected controls were subsequently tested for IgA anti-endomysial antibody and genotyped for celiac disease-associated HLA-DQ2 and -DQ8 alleles. In comparison to unaffected controls, there was not a statistically significant increase in IgA or IgG antibody reactivity to gliadin in individuals with IgA nephropathy. In addition, the levels of celiac disease-specific serologic markers, i.e., antibodies to deamidated gliadin and TG2, did not differ between IgA nephropathy patients and unaffected controls. Results of the additional anti-endomysial antibody testing and HLA genotyping were corroborative. The data from this case-control study do not reveal any evidence to suggest a significant role for celiac disease or immune reactivity to gluten in IgA nephropathy.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America; Celiac Disease Center, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Sina
authors.initials: S
authors.lastname: Moeller
authors.affiliation: Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Pietro A
authors.initials: PA
authors.lastname: Canetta
authors.affiliation: Esoterix, Inc., Laboratory Corporation of America Holdings, Englewood, Colorado, United States of America.
authors.forename: Annette K
authors.initials: AK
authors.lastname: Taylor
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America; Celiac Disease Center, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Carolina
authors.initials: C
authors.lastname: Arguelles-Grande
authors.affiliation: Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Holly
authors.initials: H
authors.lastname: Snyder
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America; Celiac Disease Center, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Green
authors.affiliation: Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kiryluk
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States of America; Celiac Disease Center, Columbia University Medical Center, New York, New York, United States of America; Institute of Human Nutrition, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Armin
authors.initials: A
authors.lastname: Alaedini
mesh_terms: D000328:Adult; D000483:Alleles; D001323:Autoantibodies / Q000276:immunology; D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood* / Q000150:complications / Q000276:immunology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D005838:Genotype; D005922:Glomerulonephritis, IGA / Q000097:blood* / Q000150:complications / Q000276:immunology*; D005983:Glutens / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011795:Surveys and Questionnaires; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005983:Glutens; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
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