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Intestinal Permeability and Antigliadin Antibody Test for Monitoring Adult Patients with Celiac Disease

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Abstract

Celiac disease causes chronic inflammation of the intestinal mucosa and reduces surface absorption; after the withdrawal of gluten from the diet, there are clinical and histologic improvements. The intestinal permeability test and serologic tests are useful for confirming the diagnosis and monitoring patients. The goal of this study is to compare the antigliadin antibody (AGA) test with the intestinal permeability test for celiac patients on a gluten-free diet. The sample consisted of 22 celiac patients who were antigliadin immunoglobulin A–positive before treatment. After 12 months on a gluten-free diet, AGA testing was repeated and the intestinal permeability test was performed. A control group was composed of 11 healthy individuals. AGA remained positive in 40.9% of celiac patients, and the mean urinary lactulose excretion was 10.27%, that of mannitol was 10.18%, and the lactulose/mannitol ratio was 1.02. In the subgroup in which antigliadin became negative (59.1%), the value for lactulose was 3.79%, that for mannitol was 11.12%, the lactulose/mannitol ratio was 0.38, and the p value was less than 0.0001, 0.66, and less than 0.0001, respectively. When the two celiac subgroups were compared with the control group, the urinary lactulose excretion and the lactulose/mannitol ratio was less in the control group, whereas urinary mannitol excretion was greater. The p values were less than 0.0001 for the three variables, suggesting persistent lesions in mucosa of both subgroups, although to a lesser degree for those that became AGA negative. It is concluded that intestinal permeability allows a more precise clinical physiopathologic correlation than antigliadin and offers more information for the monitoring of these patients.

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Acknowledgments

The authors declare the absence of any conflict of interest related to this study, whether through pharmaceutical products, equipment, or financial agents. The research was undertaken in the Programa de Pós-Graduação em Gastroenterologia, da Faculdade de Medicina da UFMG, employing appropriate resources and grants from CAPES (Coordenação de aperfeiçoamento de pessoal de ensino superior).

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Authors and Affiliations

  1. Instituto Alfa de Gastroenterologia do Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Eduardo Garcia Vilela, Maria de Lourdes de Abreu Ferrari, Henrique Osvaldo de Gama Torres, Fabiana Paiva Martins, Eugênio Marcos Andrade Goulart, Agnaldo Soares Lima & Aloíso Sales da Cunha

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  1. Eduardo Garcia Vilela
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  2. Maria de Lourdes de Abreu Ferrari
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  3. Henrique Osvaldo de Gama Torres
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Correspondence to Eduardo Garcia Vilela.

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Vilela, E.G., de Abreu Ferrari, M.d.L., de Gama Torres, H.O. et al. Intestinal Permeability and Antigliadin Antibody Test for Monitoring Adult Patients with Celiac Disease. Dig Dis Sci 52, 1304–1309 (2007). https://doi.org/10.1007/s10620-006-9511-8

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