Greenson J K, Giardiello F M, Lazenby A J, Peña S A, Bayless T M, Yardley J H
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Mod Pathol. 1990 May;3(3):259-60.
Serum antireticulin antibodies (ARAs) are often present in patients with dermatitis herpetiformis and celiac disease (CD), especially before instituting a gluten-free diet. In both collagenous colitis (CC) and lymphocytic (microscopic) colitis (LC) the colorectal mucosa shows surface epithelial damage with intraepithelial lymphocytes that is strikingly comparable to the small intestinal findings in CD. Also, CD may show subepithelial collagen deposition resembling that seen in CC. Because of these similarities, ARAs were measured in sera from patients with biopsy-proven CC and LC and compared with sera tested from CD patients. Antibody binding to reticulin was detected in frozen sections of rat liver and kidney by indirect immunofluorescent techniques. Whereas five of 14 CD patients (35.7%) had ARAs, only one of 29 CC patients (3.4%) (P = 0.010 versus CD) and none of 17 LC patients (0%) (P = 0.012 versus CD) had ARAs. The positive CC patient had IgA ARA titers of 1:20 noted in two sera taken 2 mo apart. The five positive CD patients had IgA ARA titers ranging from 1:20 to 1:320. The rare presence of ARAs noted in collagenous colitis and lymphocytic colitis was similar to its occurrence in normals, whereas the frequency of ARAs found in celiac disease (35.7%) was within the range reported for that disorder. Therefore, ARAs do not appear to be associated with CC or LC despite the morphologic similarities to CD.
血清抗网硬蛋白抗体（ARA）常出现在疱疹样皮炎和乳糜泻（CD）患者中，尤其是在采用无麸质饮食之前。在胶原性结肠炎（CC）和淋巴细胞性（显微镜下）结肠炎（LC）中，结直肠黏膜均显示表面上皮损伤伴上皮内淋巴细胞浸润，这与CD患者小肠的表现极为相似。此外，CD可能出现类似于CC的上皮下胶原沉积。由于存在这些相似性，对经活检证实的CC和LC患者的血清进行了ARA检测，并与CD患者的检测血清进行比较。通过间接免疫荧光技术在大鼠肝脏和肾脏的冰冻切片中检测抗体与网硬蛋白的结合。14例CD患者中有5例（35.7%）存在ARA，而29例CC患者中只有1例（3.4%）（与CD相比，P = 0.010）存在ARA，17例LC患者中无一例（0%）（与CD相比，P = 0.012）存在ARA。阳性的CC患者在相隔2个月采集的两份血清中IgA ARA滴度均为1:20。5例阳性CD患者的IgA ARA滴度范围为1:20至1:320。胶原性结肠炎和淋巴细胞性结肠炎中ARA的罕见出现情况与正常情况相似，而乳糜泻中ARA的出现频率（35.7%）在该疾病报道的范围内。因此，尽管CC和LC在形态学上与CD相似，但ARA似乎与CC或LC无关。
