Volta U, Corazza G R, Frisoni M, Valentini R A, Molinaro N, Bianchi F B, Gasbarrini G
I Patologia Medica e Cattedra di Semeiotica Medica, Università di Bologna, Italia.
Digestion. 1990;47(2):111-4. doi: 10.1159/000200484.
In 46 adult patients with coeliac disease, 41 (89%) of whom were positive for IgA and/or IgG antigliadin antibodies (AGA) when untreated, we investigated after a gluten-free diet the relationship between the persistence of AGA, the persistence of jejunal lesions, and the duration and compliance with the diet. IgG AGA were positive in 21 coeliac patients (46%) after variable periods of gluten-free diet and were associated with IgA positivity only in 4 cases (9%). Both IgA and IgG AGA positivity appeared to be more related to the lack of improvement of the jejunal lesions than to the strictness and duration of gluten withdrawal. Nine coeliacs showed no improvement of jejunal lesions after the gluten-free diet. Of these 9, 4 showed persistent IgA AGA, while the remaining 5 resulted IgAAGA-negative as before when untreated. Though intestinal biopsy remains the best means of determining the positive effect of gluten withdrawal, the persistence of IgA AGA in treated coeliacs is always predictive of the persistence of severe jejunal lesions. The persistence of IgG AGA, on the contrary, should be regarded as an immunological memory.
在46例成年乳糜泻患者中，41例（89%）在未治疗时IgA和/或IgG抗麦胶蛋白抗体（AGA）呈阳性，我们在无麸质饮食后研究了AGA持续存在、空肠病变持续存在与饮食持续时间及依从性之间的关系。在无麸质饮食不同时间段后，21例乳糜泻患者（46%）的IgG AGA呈阳性，且仅4例（9%）与IgA阳性相关。IgA和IgG AGA阳性似乎更多地与空肠病变未改善有关，而非与去除麸质的严格程度和持续时间有关。9例乳糜泻患者在无麸质饮食后空肠病变未改善。在这9例中，4例IgA AGA持续存在，而其余5例与未治疗时一样IgA AGA呈阴性。尽管肠道活检仍是确定去除麸质积极效果的最佳方法，但在接受治疗的乳糜泻患者中，IgA AGA持续存在总是预示着严重空肠病变会持续存在。相反，IgG AGA持续存在应被视为一种免疫记忆。
