Ruuskanen Anitta, Kaukinen Katri, Collin Pekka, Huhtala Heini, Valve Raisa, Mäki Markku, Luostarinen Liisa
Department of Neurology, Päijät-Häme Central Hospital in Lahti, Finland.
Scand J Gastroenterol. 2010 Oct;45(10):1197-202. doi: 10.3109/00365521.2010.496491.
Antigliadin antibodies (AGA) show good sensitivity but low specificity for celiac disease and can also be found in healthy individuals. However, data suggest that AGA positivity might be related to distinct disease entities such as allergy and gluten ataxia. Our aim here is to explore the clinical relevance of positive AGA in the elderly population.
Serum IgA- and IgG-class AGA and IgA-class tissue transglutaminase antibodies (tTGA) were determined in 2815 individuals aged 52-74 years. Equal numbers of AGA- and tTGA-negative participants of similar age and gender, but without known celiac disease, were randomly selected as controls. Information on clinical history was obtained from hospital records in all groups.
Altogether 381 persons were positive for IgA/IgG-class AGA; 38 (14%) of them were also positive for tTGA. Out of the biopsied subjects, 34 (100%) in the AGA+ tTGA+ group and five (9%) in AGA+ tTGA- group had celiac disease. Rheumatoid arthritis and depression were found significantly more often in AGA-positives than controls. The significance remained even when tTGA-positive and known celiac disease cases were excluded. No statistical differences were found in the occurrence of neurological diseases, diabetes, allergic and cardiovascular diseases or malignancies.
Although AGA positivity is of clinical relevance only in a subset of elderly people, it seems to be related to rheumatoid arthritis and depression, both conditions linked to celiac disease. Further studies are needed to reveal the mechanisms underlying this. The poor specificity of AGA for celiac disease was here once more in evidence.
抗麦醇溶蛋白抗体（AGA）对乳糜泻具有良好的敏感性，但特异性较低，且在健康个体中也可检测到。然而，数据表明AGA阳性可能与诸如过敏和麸质共济失调等不同的疾病实体有关。我们的目的是探讨老年人群中AGA阳性的临床相关性。
对2815名年龄在52 - 74岁的个体测定血清IgA和IgG类AGA以及IgA类组织转谷氨酰胺酶抗体（tTGA）。从年龄和性别相似、无已知乳糜泻的AGA和tTGA阴性参与者中随机选取相同数量的个体作为对照。所有组均从医院记录中获取临床病史信息。
共有381人IgA/IgG类AGA呈阳性；其中38人（14%）tTGA也呈阳性。在接受活检的受试者中，AGA + tTGA +组的34人（100%）和AGA + tTGA -组的5人（9%）患有乳糜泻。AGA阳性者中类风湿关节炎和抑郁症的发生率显著高于对照组。即使排除tTGA阳性和已知乳糜泻病例，这种显著性仍然存在。在神经系统疾病、糖尿病、过敏性疾病、心血管疾病或恶性肿瘤的发生率方面未发现统计学差异。
尽管AGA阳性仅在一部分老年人中具有临床相关性，但它似乎与类风湿关节炎和抑郁症有关，这两种疾病均与乳糜泻相关。需要进一步研究以揭示其潜在机制。 AGA对乳糜泻的低特异性在此再次得到证实。
