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Persistently positive gliadin antibodies without transglutaminase antibodies in the elderly: gluten intolerance beyond coeliac disease.
Dig Liver Dis 2011; 43(10):772-8DL

Abstract

BACKGROUND

The specificity of the conventional gliadin antibody test is considered low.

AIMS

We explored whether gliadin antibody(AGA)-positivity without tissue transglutaminase antibodies (tTGA) is persistent in the elderly population and whether such positivity indicates overt or potential coeliac disease in genetically predisposed individuals.

METHODS

AGA and tissue transglutaminase antibody were measured in 2089 elderly individuals twice with a three-year interval. AGA-positive but tissue transglutaminase antibody-negative subjects with coeliac-type human leucocyte antigen (HLA) were examined and underwent gastroduodenal endoscopy (cases). Small-bowel mucosal villous morphology and densities of CD3+ and γδ+ intraepithelial lymphocytes and the occurrence of tissue transglutaminase-specific IgA deposits were analysed. Randomly selected persistently AGA-negative age- and sex-matched subjects served as controls.

RESULTS

AGA-positivity was persistent in 81% of those initially positive. Amongst the 49 clinically studied and 36 endoscopied cases only one (2.8%) had coeliac disease. Many (54%) showed signs of inflammation in the biopsy, without villous atrophy. Coeliac-type HLA was not over-represented in the persistently AGA-positive compared to the general population. Persistently AGA-positive coeliac-type HLA-positive subjects had more gastrointestinal symptoms than AGA-negative controls.

CONCLUSIONS

AGA-positivity is often persistent. Overt coeliac disease is seldom found behind persistent AGA-positivity, but this characteristic is associated with mucosal inflammation and gastrointestinal symptoms at least in HLA-positive individuals.

Authors+Show Affiliations

Department of Neurology, Päijät-Häme Central Hospital in Lahti, 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21641886

Citation

Ruuskanen, Anitta, et al. "Persistently Positive Gliadin Antibodies Without Transglutaminase Antibodies in the Elderly: Gluten Intolerance Beyond Coeliac Disease." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 43, no. 10, 2011, pp. 772-8.
Ruuskanen A, Luostarinen L, Collin P, et al. Persistently positive gliadin antibodies without transglutaminase antibodies in the elderly: gluten intolerance beyond coeliac disease. Dig Liver Dis. 2011;43(10):772-8.
Ruuskanen, A., Luostarinen, L., Collin, P., Krekelä, I., Patrikainen, H., Tillonen, J., ... Kaukinen, K. (2011). Persistently positive gliadin antibodies without transglutaminase antibodies in the elderly: gluten intolerance beyond coeliac disease. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 43(10), pp. 772-8. doi:10.1016/j.dld.2011.04.025.
Ruuskanen A, et al. Persistently Positive Gliadin Antibodies Without Transglutaminase Antibodies in the Elderly: Gluten Intolerance Beyond Coeliac Disease. Dig Liver Dis. 2011;43(10):772-8. PubMed PMID: 21641886.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistently positive gliadin antibodies without transglutaminase antibodies in the elderly: gluten intolerance beyond coeliac disease. AU - Ruuskanen,Anitta, AU - Luostarinen,Liisa, AU - Collin,Pekka, AU - Krekelä,Ilkka, AU - Patrikainen,Heikki, AU - Tillonen,Jyrki, AU - Laurila,Kaija, AU - Haimila,Katri, AU - Partanen,Jukka, AU - Mäki,Markku, AU - Valve,Raisa, AU - Kaukinen,Katri, Y1 - 2011/06/08/ PY - 2011/02/02/received PY - 2011/03/29/revised PY - 2011/04/28/accepted PY - 2011/6/7/entrez PY - 2011/6/7/pubmed PY - 2012/2/4/medline SP - 772 EP - 8 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 43 IS - 10 N2 - BACKGROUND: The specificity of the conventional gliadin antibody test is considered low. AIMS: We explored whether gliadin antibody(AGA)-positivity without tissue transglutaminase antibodies (tTGA) is persistent in the elderly population and whether such positivity indicates overt or potential coeliac disease in genetically predisposed individuals. METHODS: AGA and tissue transglutaminase antibody were measured in 2089 elderly individuals twice with a three-year interval. AGA-positive but tissue transglutaminase antibody-negative subjects with coeliac-type human leucocyte antigen (HLA) were examined and underwent gastroduodenal endoscopy (cases). Small-bowel mucosal villous morphology and densities of CD3+ and γδ+ intraepithelial lymphocytes and the occurrence of tissue transglutaminase-specific IgA deposits were analysed. Randomly selected persistently AGA-negative age- and sex-matched subjects served as controls. RESULTS: AGA-positivity was persistent in 81% of those initially positive. Amongst the 49 clinically studied and 36 endoscopied cases only one (2.8%) had coeliac disease. Many (54%) showed signs of inflammation in the biopsy, without villous atrophy. Coeliac-type HLA was not over-represented in the persistently AGA-positive compared to the general population. Persistently AGA-positive coeliac-type HLA-positive subjects had more gastrointestinal symptoms than AGA-negative controls. CONCLUSIONS: AGA-positivity is often persistent. Overt coeliac disease is seldom found behind persistent AGA-positivity, but this characteristic is associated with mucosal inflammation and gastrointestinal symptoms at least in HLA-positive individuals. SN - 1878-3562 UR - https://www.unboundmedicine.com/medline/citation/21641886/Persistently_positive_gliadin_antibodies_without_transglutaminase_antibodies_in_the_elderly:_gluten_intolerance_beyond_coeliac_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(11)00165-4 DB - PRIME DP - Unbound Medicine ER -