Granito A, Zauli D, Muratori P, Muratori L, Grassi A, Bortolotti R, Petrolini N, Veronesi L, Gionchetti P, Bianchi F B, Volta U
Department of Internal Medicine, Alma Mater Studiorum, University of Bologna, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
Aliment Pharmacol Ther. 2005 Apr 1;21(7):881-7. doi: 10.1111/j.1365-2036.2005.02417.x.
Anti-Saccharomyces cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies are markers of Crohn's disease and ulcerative colitis respectively.
To determine the prevalence of anti-S. cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies in a large series of coeliac disease patients before and after gluten free diet, and to correlate anti-S. cerevisiae-positivity with intestinal mucosal damage.
One hundred and five consecutive coeliac disease patients and 141 controls (22 ulcerative colitis, 24 Crohn's disease, 30 primary sclerosing cholangitis, 15 postenteritis syndrome, 50 blood donors) were tested for anti-S. cerevisiae by enzyme-linked immunosorbent assay and for perinuclear anti-neutrophil cytoplasmic autoantibodies by indirect immunofluorescence.
In coeliac disease anti-S. cerevisiae (immunoglobulin G and/or immunoglobulin A) were slightly less frequent (59%) than in Crohn's disease (75%, P = 0.16) and significantly more frequent than in ulcerative colitis (27%), primary sclerosing cholangitis (30%), postenteritis syndrome (26%) and blood donors (4%) (P = 0.009, P = 0.0002, P = 0.025, P < 0.0001). No correlation was found between anti-S. cerevisiae and degree of mucosal damage. Perinuclear anti-neutrophil cytoplasmic autoantibodies were detected only in one coeliac. After gluten free diet the disappearance of anti-S. cerevisiae-immunoglobulin A (93%) was more frequent than that of immunoglobulin G (17%, P = 0.0001); perinuclear anti-neutrophil cytoplasmic autoantibodies disappeared in the only coeliac positive at diagnosis.
More than half of untreated coeliacs are anti-S. cerevisiae-positive irrespective of the severity of mucosal damage. Differently from immunoglobulin A, anti-S. cerevisiae-immunoglobulin G persisted in more than 80% after gluten free diet. The high prevalence of anti-S. cerevisiae in coeliac disease suggests that they may be the effect of a non-specific immune response in course of chronic small bowel disease.
抗酿酒酵母抗体和核周型抗中性粒细胞胞浆自身抗体分别是克罗恩病和溃疡性结肠炎的标志物。
确定大量乳糜泻患者在无麸质饮食前后抗酿酒酵母抗体和核周型抗中性粒细胞胞浆自身抗体的患病率，并将抗酿酒酵母抗体阳性与肠道黏膜损伤相关联。
对105例连续的乳糜泻患者和141名对照者（22例溃疡性结肠炎、24例克罗恩病、30例原发性硬化性胆管炎、15例肠炎后综合征、50名献血者）进行抗酿酒酵母抗体的酶联免疫吸附测定及核周型抗中性粒细胞胞浆自身抗体的间接免疫荧光检测。
在乳糜泻患者中，抗酿酒酵母抗体（免疫球蛋白G和/或免疫球蛋白A）的出现频率略低于克罗恩病患者（59%比75%，P = 0.16），但显著高于溃疡性结肠炎患者（27%）、原发性硬化性胆管炎患者（30%）、肠炎后综合征患者（26%）及献血者（4%）（P = 0.009、P = 0.0002、P = 0.025、P < 0.0001）。未发现抗酿酒酵母抗体与黏膜损伤程度之间存在相关性。仅在1例乳糜泻患者中检测到核周型抗中性粒细胞胞浆自身抗体。无麸质饮食后，抗酿酒酵母免疫球蛋白A消失（93%）的频率高于免疫球蛋白G（17%，P = 0.0001）；核周型抗中性粒细胞胞浆自身抗体在诊断时唯一阳性的乳糜泻患者中消失。
超过半数未经治疗的乳糜泻患者抗酿酒酵母抗体呈阳性，与黏膜损伤严重程度无关。与免疫球蛋白A不同，无麸质饮食后超过80%的抗酿酒酵母免疫球蛋白G持续存在。乳糜泻患者中抗酿酒酵母抗体的高患病率表明，它们可能是慢性小肠疾病过程中非特异性免疫反应的结果。
