ANTIBODIES TO GLUTEN AND RETICULIN IN GASTROINTESTINAL-DISEASES

Abstract

Antibodies to reticulin were found in 33% of celiac patients on a normal diet. These antibodies were in only 11% of celiac patients on a gluten-free diet. In patients with dermatitis herpitiformis, 12% had these antibodies; the highest frequency in the other diseases studied (Crohn''s disease, ulcerative colitis, cystic fibrosis and recurrent diarrhea) was 7% (compared to 2% in healthy controls). Antibodies to gluten, demonstrated with the immunofluorescence technique, were in all celiac children on a normal diet that were studied, and in half of the adults with the untreated disease. In children and adults on a gluten-free diet these frequencies decreased to 87 and 32%. In Crohn''s disease, cystic fibrosis, recurrent diarrhea, dermatitis herpetiformis and ulcerative colitis, the frequencies were 52, 42, 37, 18 and 18%, respectively, and in 4% of controls. Antibodies to gluten were sensitive markers for gastrointestinal diseases, but were not specific for gluten enteropathy. Antibodies to reticulin were less sensitive but of far greater specificity for celiac disease. Gluten antibodies were of the Ig[immunoglobulin]A, IgM and IgG classes; antibodies to reticulin were only of the IgA and IgG classes. Both types of antibody were non-complement-fixing. Autoantibodies to smooth muscle were in 5% of the celiac patients (and in 0% of controls). No relationship with hepatic complications was found. In the patients with dermatitis herpetiformis, autoantibodies to gastric parietal cells were in 24% (and in 5% of controls). No relationship was established between the occurrence of HLA-B8 and the presence or absence of any of the antibodies studied.