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Gluten-dependent small bowel mucosal transglutaminase 2-specific IgA deposits in overt and mild enteropathy coeliac disease.
J Pediatr Gastroenterol Nutr 2008; 47(4):436-42JP

Abstract

OBJECTIVES

In coeliac disease, immunoglobulin (Ig)A-class autoantibodies against transglutaminase-2 are produced in the small intestinal mucosa, where they are deposited extracellularly. It remains unclear whether positive intestinal transglutaminase-2-targeted IgA deposits in subjects having normal small bowel mucosal morphology are signs of early-stage coeliac disease. We evaluated the gluten dependency of these deposits in overt and mild enteropathy coeliac disease.

PATIENTS AND METHODS

All together 48 subjects suspected of coeliac disease but having normal small bowel mucosal villi were enrolled; 28 of them had latent coeliac disease. The remaining 20 having positive intestinal IgA deposits adopted a gluten-free diet before villous atrophy had developed. For comparison, 13 patients with overt coeliac disease and 42 noncoeliac controls were studied. Small bowel mucosal transglutaminase-2-specific autoantibodies were compared with villous morphology, intraepithelial lymphocyte densities, and serum coeliac autoantibodies.

RESULTS

Intestinal IgA deposits were seen in all but 1 of the patients with latent coeliac disease, when the morphology was still intact; the intensity of these deposits increased as villous atrophy developed and decreased again on a gluten-free diet. In 20 patients with intestinal IgA deposits in normal villi, the intensity of the deposits decreased with the diet similarly to that seen in patients with overt coeliac disease. Mucosal IgA deposits were seen initially only in 5% of noncoeliac controls and in 8% after extended gluten consumption.

CONCLUSIONS

The response of small bowel mucosal transglutaminase-2-specific IgA deposits for dietary intervention was similar in overt and mild enteropathy coeliac disease. Detection of such IgA deposits thus offers a good diagnostic tool to uncover early-stage coeliac disease.

Authors+Show Affiliations

Pediatric Research Centre, University of Tampere, 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 available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18852635

Citation

Koskinen, Outi, et al. "Gluten-dependent Small Bowel Mucosal Transglutaminase 2-specific IgA Deposits in Overt and Mild Enteropathy Coeliac Disease." Journal of Pediatric Gastroenterology and Nutrition, vol. 47, no. 4, 2008, pp. 436-42.
Koskinen O, Collin P, Korponay-Szabo I, et al. Gluten-dependent small bowel mucosal transglutaminase 2-specific IgA deposits in overt and mild enteropathy coeliac disease. J Pediatr Gastroenterol Nutr. 2008;47(4):436-42.
Koskinen, O., Collin, P., Korponay-Szabo, I., Salmi, T., Iltanen, S., Haimila, K., ... Kaukinen, K. (2008). Gluten-dependent small bowel mucosal transglutaminase 2-specific IgA deposits in overt and mild enteropathy coeliac disease. Journal of Pediatric Gastroenterology and Nutrition, 47(4), pp. 436-42. doi:10.1097/MPG.0b013e31817b6dec.
Koskinen O, et al. Gluten-dependent Small Bowel Mucosal Transglutaminase 2-specific IgA Deposits in Overt and Mild Enteropathy Coeliac Disease. J Pediatr Gastroenterol Nutr. 2008;47(4):436-42. PubMed PMID: 18852635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gluten-dependent small bowel mucosal transglutaminase 2-specific IgA deposits in overt and mild enteropathy coeliac disease. AU - Koskinen,Outi, AU - Collin,Pekka, AU - Korponay-Szabo,Ilma, AU - Salmi,Teea, AU - Iltanen,Sari, AU - Haimila,Katri, AU - Partanen,Jukka, AU - Mäki,Markku, AU - Kaukinen,Katri, PY - 2008/10/15/pubmed PY - 2009/2/10/medline PY - 2008/10/15/entrez SP - 436 EP - 42 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 47 IS - 4 N2 - OBJECTIVES: In coeliac disease, immunoglobulin (Ig)A-class autoantibodies against transglutaminase-2 are produced in the small intestinal mucosa, where they are deposited extracellularly. It remains unclear whether positive intestinal transglutaminase-2-targeted IgA deposits in subjects having normal small bowel mucosal morphology are signs of early-stage coeliac disease. We evaluated the gluten dependency of these deposits in overt and mild enteropathy coeliac disease. PATIENTS AND METHODS: All together 48 subjects suspected of coeliac disease but having normal small bowel mucosal villi were enrolled; 28 of them had latent coeliac disease. The remaining 20 having positive intestinal IgA deposits adopted a gluten-free diet before villous atrophy had developed. For comparison, 13 patients with overt coeliac disease and 42 noncoeliac controls were studied. Small bowel mucosal transglutaminase-2-specific autoantibodies were compared with villous morphology, intraepithelial lymphocyte densities, and serum coeliac autoantibodies. RESULTS: Intestinal IgA deposits were seen in all but 1 of the patients with latent coeliac disease, when the morphology was still intact; the intensity of these deposits increased as villous atrophy developed and decreased again on a gluten-free diet. In 20 patients with intestinal IgA deposits in normal villi, the intensity of the deposits decreased with the diet similarly to that seen in patients with overt coeliac disease. Mucosal IgA deposits were seen initially only in 5% of noncoeliac controls and in 8% after extended gluten consumption. CONCLUSIONS: The response of small bowel mucosal transglutaminase-2-specific IgA deposits for dietary intervention was similar in overt and mild enteropathy coeliac disease. Detection of such IgA deposits thus offers a good diagnostic tool to uncover early-stage coeliac disease. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/18852635/Gluten_dependent_small_bowel_mucosal_transglutaminase_2_specific_IgA_deposits_in_overt_and_mild_enteropathy_coeliac_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=18852635 DB - PRIME DP - Unbound Medicine ER -