Sima Hamidreza, Hekmatdoost Azita, Ghaziani Tahereh, Alavian Seyed Moayyed, Mashayekh Ameneh, Zali Mohammad Reza
Research Institute for Gasteroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2010 Sep;9(3):157-62.
Celiac disease has been associated with other autoimmune disorders such as autoimmune hepatitis, moreover it is known that T cell mediated immune response to dietary gluten and released cytokines are important for the entheropathy seen in celiac disease. We investigated celiac autoantibodies in patients with autoimmune hepatitis (AIH), and chronic hepatitis B (CHB).Sera from 84 patients with Autoimmune Hepatitis (AIH) type 1 and 88 patients with Chronic Hepatitis B (CHB) were tested for Immunoglobulin A and G antibodies to Gliadin, Immunoglobulin A antibodies to tissue transglutaminase using enzyme immunoassay, and Immunoglobulin A anti-endomysial antibodies by both indirect immunofluorescence, and enzyme immunoassay. The patients positive for anti-endomysial antibodies and/or anti tissue transglutaminase antibodies were considered for deuodenal biopsy. The study was approved by Research Center for Gastroenterology and Liver Disease Ethics Committee and all patients gave their written informed consent to participate.Immunoglobulin A anti-endomysial and Immunoglobulin A anti-gliadin antibodies were positive in two out of 84 patients with AIH. Moreover, Immunoglobulin A anti-gliadin antibodies were positive in another patient who was also positive for anti tissue transglutaminase antibodies. Tissue transglutaminase antibodies were positive in eight (9.1%) of 88 patients with CHB, two of which were also positive for anti-endomysial antibodies. One of the patients with CHB was only positive for anti-endomysial antibodies.Compared with the general population, the prevalence of celiac autoantibodies in CHB and AIH patients is relatively high, and it is noteworthy that most positive patients were asymptomatic for celiac disease. We suggest screening for celiac disease before and during treatment in patients with viral and autoimmune hepatitis.
乳糜泻与其他自身免疫性疾病如自身免疫性肝炎有关，此外，已知对膳食麸质的T细胞介导免疫反应和释放的细胞因子对于乳糜泻中所见的小肠病很重要。我们调查了自身免疫性肝炎（AIH）和慢性乙型肝炎（CHB）患者中的乳糜泻自身抗体。使用酶免疫测定法检测了84例1型自身免疫性肝炎（AIH）患者和88例慢性乙型肝炎（CHB）患者的血清中针对麦醇溶蛋白的免疫球蛋白A和G抗体、针对组织转谷氨酰胺酶的免疫球蛋白A抗体，并通过间接免疫荧光法和酶免疫测定法检测了免疫球蛋白A抗肌内膜抗体。抗肌内膜抗体和/或抗组织转谷氨酰胺酶抗体呈阳性的患者接受十二指肠活检。该研究获得了胃肠病学和肝病研究中心伦理委员会的批准，所有患者均签署了书面知情同意书以参与研究。84例AIH患者中有2例免疫球蛋白A抗肌内膜和免疫球蛋白A抗麦醇溶蛋白抗体呈阳性。此外，另一名抗组织转谷氨酰胺酶抗体也呈阳性的患者免疫球蛋白A抗麦醇溶蛋白抗体呈阳性。88例CHB患者中有8例（9.1%）组织转谷氨酰胺酶抗体呈阳性，其中2例抗肌内膜抗体也呈阳性。1例CHB患者仅抗肌内膜抗体呈阳性。与普通人群相比，CHB和AIH患者中乳糜泻自身抗体的患病率相对较高，值得注意 的是，大多数阳性患者无乳糜泻症状。我们建议在病毒性和自身免疫性肝炎患者治疗前和治疗期间筛查乳糜泻。
