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Elevated Serum Anti-Saccharomyces cerevisiae, Anti-I2 and Anti-OmpW Antibody Levels in Patients with Suspicion of Celiac Disease

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Abstract

Objectives

Expression of anti-Saccharomyces cerevisiae antibodies (ASCA) identifies patients and individuals at risk for Crohn’s disease and has also been reported in 40–60% of celiac disease (CD) cases, suggesting a role of host response to enteric microbiota in the development of inflammatory lesions. In this prospective study in patients with suspicion of CD, we evaluate the frequency and association of ASCA to serological responses for other host microbial targets formally associated with Crohn’s disease, including the Pseudomonas fluorescens associated sequence I2 and a Bacteroides caccae TonB-linked outer membrane protein, OmpW.

Methods

Small bowel mucosal biopsies were taken from 242 patients with suspicion of CD, their sera were tested for antibodies to tissue transglutaminase (tTG), ASCA, I2, and OmpW. Eighty adult healthy blood donors were used as controls.

Results

The diagnosis of CD was confirmed on biopsy in 134 cases. The occurrence of ASCA and I2 positivity was significantly higher in adult CD patients than in patients with non-CD disease. Anti-I2 levels in the sera were significantly higher in adult CD patients than in non-CD disease or the controls and anti-OmpW levels in CD and non-CD patients when compared to controls. Positive seroreactivity to OmpW seemed to increase with age. Of the CD patients, 90% were seropositive for at least one microbial antigen tested.

Conclusions

This study demonstrates a mosaic of disease-related serological responses to microbial antigens in patients with CD. Immune responses to commensal enteric bacteria may play a role in the small intestine mucosal damage in CD.

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Acknowledgements

This study was supported by grants from the Paediatric Research Foundation, the Competitive Research Funding of the Pirkanmaa Hospital District, the Finnish Gastroenterology Association (MA), the Mary and Georg C Ehrnrooth Foundation and, and NIH PO1-DK 46763 (J.B.). We would like to thank Leena Ripsaluoma, Marja-Leena Koskinen, and Mikko Hurme for excellent assistance in preparing this study

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Authors and Affiliations

  1. Paediatric Research Centre and Medical School, University of Tampere and Tampere University Hospital, Tampere, Finland

    Sara Ashorn, Merja Ashorn, Katri Kaukinen, Markku Mäki & Sari Iltanen

  2. Department of Paediatrics, Tampere University Hospital, Tampere, Finland

    Merja Ashorn & Markku Mäki

  3. Department of Microbiology, Tampere University Hospital, Tampere, Finland

    Hanna Raukola

  4. Department of Pathology, Tampere University Hospital, Tampere, Finland

    Immo Rantala

  5. Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland

    Katri Kaukinen & Pekka Collin

  6. Institute of Medical Technology, University of Tampere, Tampere, Finland

    Tuuli Välineva

  7. Research Unit, Tampere University Hospital and Tampere School of Public Health, University of Tampere, Tampere, Finland

    Tiina Luukkaala

  8. Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA

    Bo Wei & Jonathan Braun

  9. Paediatric Research Centre, University of Tampere, Building FM3, 3rd floor, 33014, Tampere, Finland

    Sari Iltanen

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  1. Sara Ashorn
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Correspondence to Sari Iltanen.

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Ashorn, S., Raukola, H., Välineva, T. et al. Elevated Serum Anti-Saccharomyces cerevisiae, Anti-I2 and Anti-OmpW Antibody Levels in Patients with Suspicion of Celiac Disease. J Clin Immunol 28, 486–494 (2008). https://doi.org/10.1007/s10875-008-9200-9

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