IMMUNE REACTION AGAINST CYTOSKELETON IN COELIAC DISEASE

Abstract

28 Background The cytoskeleton actin network of intestinal microvilli has been found to be rapidly impaired after gluten challenge in coeliac disease (CD). The aim of this study was to investigate the presence in both children and adults of an immune reaction towards cytoskeleton structures such as actin filaments. Patients and Methods Eighty-one CD patients (51 children and 30 adults) were studied at our outpatient clinics from 1996 to 1998 by indirect immunofluorescence (IF), ELISA and Western-blotting for anti-actin (AAA) and other non-organ specific autoantibodies before and after a gluten-free diet (GFD). Sixteen patients with autoimmune hepatitis type 1 (AH-1), 10 with Crohn's disease and 60 healthy subjects were studied as controls. Findings Sixty-one out eighty-five CD patients, of whom 31/34 were adults (91%) and 30/51 children (58%), were positive for IgA AAA and/or IgG AAA. IgA AAA were strongly correlated with the most severe forms of intestinal villous atrophy (p<0.0001; RR: 58.7). After GFD, AAA became undetectable within five months. CD was associated with AH-1 in 2/16 patients. Interpretation We describe an immune reaction against the cytoskeleton, besides the one against the extracellular matrix in both children and adults with CD. Since AAA are strongly associated with the most severe degrees of villous atrophy, they could represent a useful serological marker of intestinal villous atrophy in CD.