Serological Investigation of Persistent Villous Atrophy in Celiac Disease.
Serological Investigation of Persistent Villous Atrophy in Celiac Disease.
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DOI：
10.14309/ctg.0000000000000639
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发表时间：
2023-12-01
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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作者：
持续性绒毛萎缩(VA)在乳糜泻(CED)中并不少见，而患者则服用无麸质饮食(GFD)。我们对122份血清样本进行了回顾性研究，这些样本来自对照组和CED患者，无论是在最初诊断时还是在内窥镜检查期间的随访中。这些样本被分成3组：非腹水对照组、非VA CED组(Marsh评分0~2)和VA CED组(Marsh评分3a~3c)。我们建立了一种室内多重检测来确定VA的潜在血清生物标志物。我们评估了已报道的影响小肠的自身抗体，包括针对组织转谷氨酰胺酶(TTG)、干扰素、绒毛蛋白、肌动蛋白、自身免疫性肠病相关75 kDa抗原(AIE-75)和色氨酸羟化酶(TPH)-1的IgA和IgG抗体，以及27种细胞因子。定量的载脂蛋白包括载脂蛋白A1、载脂蛋白B-100和载脂蛋白A4，它们主要由肠上皮产生或在绒毛中特异表达。自身抗体水平较高的只有tTG抗体，这在CED的初始诊断中表现良好，但在随访中预测VA的效果不佳，因为14.6%的VA患者随访时tTG-IgA水平较低。增加稀释度提高了tTG-IgA的定量，特别是当抗体水平极高时，但对VA检测没有显著改善。在低tTG-IgA和持续性VA患者中，有2例患者的促炎细胞因子水平较高。VA CED组低密度脂蛋白胆固醇水平中位数显著低于对照组(P=0.03)。在有无VA的患者中，载脂蛋白水平相似，但在服用GFD或不服用GFD的患者之间存在差异。TTG-IgA作为预测VA的生物标志物在GFD上是次要的。持续性VA与低密度脂蛋白胆固醇水平有关，部分与持续性高致炎细胞因子有关。
Persistent villous atrophy (VA) is not uncommon in celiac disease (CeD) while patients take a gluten-free diet (GFD). We conducted a retrospective study with 122 serum samples collected from controls and patients with CeD either at the initial diagnosis or at the follow-up during endoscopy. These samples were assigned to 3 groups: nonceliac control, non-VA CeD (Marsh score 0–2), and VA CeD (Marsh score 3a-3c). We established an in-house multiplex assay to identify potential serological biomarkers for VA. We assessed autoantibodies reported to affect the small intestine, including IgA and IgG antibodies against tissue transglutaminase (tTG), interferons, villin, actin, autoimmune enteropathy-related 75 kDa antigen (AIE-75), and tryptophan hydroxylase (TPH)-1, as well as 27 cytokines. The apolipoproteins quantified included apo A1, apo B-100, and apo A4, which were produced predominantly by the intestinal epithelium or expressed specifically in villi. Autoantibody levels were high only for tTG antibodies, which performed well in initial CeD diagnosis, but suboptimally for VA prediction during follow-up, because 14.6% of the follow-up patients with VA had low tTG-IgA. Increasing dilution improved tTG-IgA quantification, particularly when the antibody levels were extremely high but did not significantly improve VA detection. Among those with low tTG-IgA and persistent VA, high proinflammatory cytokines were observed in 2 patients. Median low-density lipoprotein cholesterol levels were significantly lower in the VA CeD group (P = 0.03). Apolipoprotein levels were similar in patients with and without VA but diverged between those on a GFD or not. tTG-IgA as a biomarker is suboptimal for VA prediction while on a GFD. Persistent VA is associated with low low-density lipoprotein cholesterol levels and partially related to persistent high proinflammatory cytokines.
影响因子：
3.7
作者：
Lampasona V;Passerini L;Barzaghi F;Lombardoni C;Bazzigaluppi E;Brigatti C;Bacchetta R;Bosi E
通讯作者：
Bosi E