Kárpáti S, Bürgin-Wolff A, Krieg T, Meurer M, Stolz W, Braun-Falco O
Department of Dermatology, Heim Pál Hospital for Children, Budapest, Hungary.
Lancet. 1990 Dec 1;336(8727):1335-8. doi: 10.1016/0140-6736(90)92893-m.
Jejunal histology and the presence of serum IgA antibodies (JAB) binding to human jejunum in vitro were studied in 139 children with severe malabsorptive symptoms. Among 33 children with confirmed coeliac disease (ESPGAN criteria), 13 (93%) of 14 sampled before starting on a gluten-free diet had JAB, none of 21 sampled had JAB while on a gluten-free diet of long duration, and 90% of 30 sampled during gluten challenge had JAB. 53 children had severe jejunal villous atrophy (probable coeliac disease): 71% of those younger than 2 years and 94% of those aged 2-18 years had JAB during gluten intake. JAB could not be detected in 53 disease control patients (normal jejunal histology) and in 3 coeliac disease patients with selective IgA deficiency. Simultaneous determination of antigliadin (AGA) and antiendomysium (EMA) levels, and gliadin and tissue absorption studies, showed that JAB and AGA are different, whereas JAB and EMA are probably identical. IgA JAB could be the target-organ-related autoantibodies in coeliac disease.
对139名有严重吸收不良症状的儿童进行了空肠组织学检查以及血清IgA抗体（JAB）与人体空肠体外结合情况的研究。在33名确诊为乳糜泻（ESPGAN标准）的儿童中，14名在开始无麸质饮食前采样的儿童中有13名（93%）有JAB，21名长期接受无麸质饮食采样的儿童中无一例有JAB，30名在麸质激发试验期间采样的儿童中有90%有JAB。53名儿童有空肠严重绒毛萎缩（可能为乳糜泻）：2岁以下儿童中有71%以及2 - 18岁儿童中有94%在摄入麸质期间有JAB。在53名疾病对照患者（空肠组织学正常）和3名选择性IgA缺乏的乳糜泻患者中未检测到JAB。同时测定抗麦醇溶蛋白（AGA）和抗肌内膜（EMA）水平以及麦醇溶蛋白和组织吸收研究表明，JAB与AGA不同，而JAB与EMA可能相同。IgA JAB可能是乳糜泻中与靶器官相关的自身抗体。
