Fabris Martina, Visentini Daniela, De Re Valli, Picierno Alessia, Maieron Roberto, Cannizzaro Renato, Villalta Danilo, Curcio Francesco, De Vita Salvatore, Tonutti Elio
Clinic of Rheumatology, DPMSC, University of Udine, Udine, Italy.
Scand J Gastroenterol. 2007 Dec;42(12):1434-9. doi: 10.1080/00365520701452225.
The B cell-activating factor of the tumour necrosis factor (TNF) family (BAFF) was recently described as a critical survival factor for B cells, and its expression is increased in several autoimmune diseases. Abnormal production of BAFF disturbs immune tolerance allowing the survival of autoreactive B cells and participates in the progression of B-cell lymphomas. Coeliac disease (CD) is a common autoimmune disorder induced by gluten intake in genetically predisposed individuals, associated with autoantibody production and with an increased risk of lymphoma at follow-up. The purpose of this study was to investigate the possible implications of BAFF in CD.
Seventy-three patients with small-bowel biopsies and laboratory-proven diagnosis of CD were included in the study. All serum samples were analysed before the start of a gluten-free diet (GFD). In 12 cases, one or more samples were analysed during follow-up of the GFD. Seventy-seven blood donors were taken as controls. Serum BAFF levels and anti-transglutaminase (a-tTG) antibodies were assessed by ELISA and endomysial antibodies by indirect immunofluorescence.
Serum BAFF levels appeared to be significantly more elevated in CD patients than in controls (p<0.0001) and, compared with other autoimmune diseases where BAFF is increased, a much larger percentage (80.8%) of CD patients presented BAFF levels above the normal range. In addition, serum BAFF levels were found to correlate with a-tTG antibody levels (p =0.0007) and there was a significant reduction of BAFF after introduction of a GFD.
BAFF may represent a possible pathogenic factor in CD. Its implications for the diagnosis, prognosis and treatment of CD should also be assessed.
肿瘤坏死因子（TNF）家族的B细胞激活因子（BAFF）最近被描述为B细胞的关键生存因子，其表达在几种自身免疫性疾病中增加。BAFF的异常产生会扰乱免疫耐受，使自身反应性B细胞得以存活，并参与B细胞淋巴瘤的进展。乳糜泻（CD）是一种常见的自身免疫性疾病，由遗传易感个体摄入麸质引起，与自身抗体产生有关，且随访时淋巴瘤风险增加。本研究的目的是调查BAFF在CD中的可能影响。
本研究纳入了73例经小肠活检及实验室确诊为CD的患者。所有血清样本均在开始无麸质饮食（GFD）前进行分析。12例患者在GFD随访期间进行了一个或多个样本的分析。77名献血者作为对照。通过酶联免疫吸附测定（ELISA）评估血清BAFF水平和抗转谷氨酰胺酶（a-tTG）抗体，通过间接免疫荧光评估肌内膜抗体。
CD患者的血清BAFF水平似乎显著高于对照组（p<0.0001），与BAFF升高的其他自身免疫性疾病相比，CD患者中BAFF水平高于正常范围的比例要大得多（80.8%）。此外，发现血清BAFF水平与a-tTG抗体水平相关（p =0.0007），引入GFD后BAFF显著降低。
BAFF可能是CD的一个潜在致病因素。还应评估其对CD诊断、预后和治疗的影响。
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