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Small-bowel mucosal transglutaminase 2-specific IgA deposits in coeliac disease without villous atrophy: a prospective and randomized clinical study.
Scand J Gastroenterol 2005; 40(5):564-72SJ

Abstract

OBJECTIVE

In coeliac disease, autoantibodies directed against transglutaminase 2 are produced in small-bowel mucosa, and they have been found to be deposited extracellularly. The aim of this study was to investigate whether such mucosal IgA deposits are important in the diagnostic work-up of early-stage coeliac disease without small-bowel mucosal villous atrophy.

MATERIAL AND METHODS

Forty-one adults suspected of coeliac disease owing to increased density of mucosal gamma(delta)+ intraepithelial lymphocytes but normal villous morphology were randomized to gluten challenge or a gluten-free diet for 6 months. Clinically and histologically verified gluten dependency was compared with existence of small-bowel mucosal transglutaminase 2-specific extracellular IgA deposits and (coeliac disease-type) HLA DQ2 and DQ8; 34 non-coeliac subjects and 18 patients with classical coeliac disease served as controls.

RESULTS

Of the 41 patients, 5 in the challenge group and 6 in the gluten-free diet group were clinically gluten sensitive; all 11 had HLA DQ2 or DQ8. Ten of these 11 patients showed transglutaminase 2-targeted mucosal IgA deposits, which were dependent on gluten consumption. Minimal IgA deposits were seen in only 3 out of 30 patients with suspected coeliac disease without any clinically detected gluten dependency. The deposits were found in all classical coeliac patients and in none of the non-coeliac control subjects.

CONCLUSIONS

Clinically pertinent coeliac disease exists despite normal small-bowel mucosal villous architecture. Mucosal transglutaminase 2-specific IgA deposits can be utilized in detecting such patients with genetic gluten intolerance.

Authors+Show Affiliations

Department of Tissue Typing, Finnish Red Cross Blood Service, Helsinki, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16036509

Citation

Kaukinen, Katri, et al. "Small-bowel Mucosal Transglutaminase 2-specific IgA Deposits in Coeliac Disease Without Villous Atrophy: a Prospective and Randomized Clinical Study." Scandinavian Journal of Gastroenterology, vol. 40, no. 5, 2005, pp. 564-72.
Kaukinen K, Peräaho M, Collin P, et al. Small-bowel mucosal transglutaminase 2-specific IgA deposits in coeliac disease without villous atrophy: a prospective and randomized clinical study. Scand J Gastroenterol. 2005;40(5):564-72.
Kaukinen, K., Peräaho, M., Collin, P., Partanen, J., Woolley, N., Kaartinen, T., ... Korponay-Szabo, I. (2005). Small-bowel mucosal transglutaminase 2-specific IgA deposits in coeliac disease without villous atrophy: a prospective and randomized clinical study. Scandinavian Journal of Gastroenterology, 40(5), pp. 564-72.
Kaukinen K, et al. Small-bowel Mucosal Transglutaminase 2-specific IgA Deposits in Coeliac Disease Without Villous Atrophy: a Prospective and Randomized Clinical Study. Scand J Gastroenterol. 2005;40(5):564-72. PubMed PMID: 16036509.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small-bowel mucosal transglutaminase 2-specific IgA deposits in coeliac disease without villous atrophy: a prospective and randomized clinical study. AU - Kaukinen,Katri, AU - Peräaho,Markku, AU - Collin,Pekka, AU - Partanen,Jukka, AU - Woolley,Nina, AU - Kaartinen,Tanja, AU - Nuutinen,Tuula, AU - Halttunen,Tuula, AU - Mäki,Markku, AU - Korponay-Szabo,Ilma, PY - 2005/7/23/pubmed PY - 2005/9/3/medline PY - 2005/7/23/entrez SP - 564 EP - 72 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 40 IS - 5 N2 - OBJECTIVE: In coeliac disease, autoantibodies directed against transglutaminase 2 are produced in small-bowel mucosa, and they have been found to be deposited extracellularly. The aim of this study was to investigate whether such mucosal IgA deposits are important in the diagnostic work-up of early-stage coeliac disease without small-bowel mucosal villous atrophy. MATERIAL AND METHODS: Forty-one adults suspected of coeliac disease owing to increased density of mucosal gamma(delta)+ intraepithelial lymphocytes but normal villous morphology were randomized to gluten challenge or a gluten-free diet for 6 months. Clinically and histologically verified gluten dependency was compared with existence of small-bowel mucosal transglutaminase 2-specific extracellular IgA deposits and (coeliac disease-type) HLA DQ2 and DQ8; 34 non-coeliac subjects and 18 patients with classical coeliac disease served as controls. RESULTS: Of the 41 patients, 5 in the challenge group and 6 in the gluten-free diet group were clinically gluten sensitive; all 11 had HLA DQ2 or DQ8. Ten of these 11 patients showed transglutaminase 2-targeted mucosal IgA deposits, which were dependent on gluten consumption. Minimal IgA deposits were seen in only 3 out of 30 patients with suspected coeliac disease without any clinically detected gluten dependency. The deposits were found in all classical coeliac patients and in none of the non-coeliac control subjects. CONCLUSIONS: Clinically pertinent coeliac disease exists despite normal small-bowel mucosal villous architecture. Mucosal transglutaminase 2-specific IgA deposits can be utilized in detecting such patients with genetic gluten intolerance. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/16036509/Small_bowel_mucosal_transglutaminase_2_specific_IgA_deposits_in_coeliac_disease_without_villous_atrophy:_a_prospective_and_randomized_clinical_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520510023422 DB - PRIME DP - Unbound Medicine ER -