Roggenbuck Dirk, Vermeire Severine, Hoffman Ilse, Reinhold Dirk, Schierack Peter, Goihl Alexander, von Arnim Ulrike, De Hertogh Gert, Polymeros Dimitrios, Bogdanos Dimitrios P, Bossuyt Xavier
Clin Chem Lab Med. 2015 Aug;53(9):1349-57. doi: 10.1515/cclm-2014-0238.
Autoantibodies to exocrine-pancreatic glycoprotein 2 (anti-GP2) are Crohn's disease (CD) markers. However, CD-specific antibodies have also been found in celiac-disease (CeD) patients, in which type 1 diabetes-specific autoantibodies against endocrine pancreatic targets can be present. We investigated whether anti-GP2 are also present in CeD, a disease like CD which is also characterised by intestinal mucosal inflammation with barrier impairment.
Antibodies against GP2, tissue transglutaminase (tTG), deamidated gliadin (dGD), glutamic decarboxylase (GAD), and islet antigen-2 (IA2) were tested in sera from 73 CD patients, 90 blood donors (BD), and 79 (58 de novo) CeD patients (2 consecutive sera were available from 40 patients).
IgA and/or IgG anti-GP2 were found in 15/79 (19.0%) CeD patients on at least one occasion, in 25/73 (34.2%) CD patients, and in 4/90 (4.4%) BD (CeD vs. CD, p=0.042; BD vs. CeD and CD, p<0.001, respectively). Amongst the 58 de novo CeD patients, anti-GP2 IgA and/or IgG were present in 11 (19.0%). Anti-GP2 IgA was significantly less prevalent in CeD compared with CD (p=0.004). Anti-GP2 IgA and IgG in CD patients demonstrated a significantly higher median level compared to patients with CeD (p<0.001, p=0.008, respectively). IgA anti-GP2 levels correlated significantly with IgA anti-tTG and anti-dGD levels in CeD Spearman's coefficient of rank correlation (ρ)=0.42, confidence interval (CI): 0.26-0.56, p<0.001; ρ=0.54, CI 0.39-0.65, p<0.001, respectively.
The presence of anti-GP2 in CeD patients supports the notion that loss of tolerance to GP2 can probably be a manifestation of an autoinflammatory process in this intestinal disorder.
外分泌胰腺糖蛋白2自身抗体（抗GP2）是克罗恩病（CD）的标志物。然而，在乳糜泻（CeD）患者中也发现了CD特异性抗体，这些患者可能存在针对内分泌胰腺靶点的1型糖尿病特异性自身抗体。我们调查了抗GP2是否也存在于CeD中，CeD是一种与CD类似的疾病，其特征也是肠道黏膜炎症伴屏障功能受损。
检测了73例CD患者、90例献血者（BD）以及79例（58例初发）CeD患者（40例患者可提供两份连续血清样本）血清中抗GP2、组织转谷氨酰胺酶（tTG）、去酰胺麦醇溶蛋白（dGD）、谷氨酸脱羧酶（GAD）和胰岛抗原2（IA2）抗体。
至少在一次检测中，15/79（19.0%）的CeD患者、25/73（34.2%）的CD患者以及4/90（4.4%）的BD患者检测到IgA和/或IgG抗GP2（CeD与CD相比，p = 0.042；BD与CeD及CD相比，p分别<0.001）。在58例初发CeD患者中，11例（19.0%）存在抗GP IgA和/或IgG。与CD相比，CeD患者中抗GP2 IgA的患病率显著更低（p = 0.004）。与CeD患者相比，CD患者中抗GP2 IgA和IgG的中位数水平显著更高（分别为p<0.001，p = 0.008）。在CeD中，IgA抗GP2水平与IgA抗tTG和抗dGD水平显著相关（Spearman等级相关系数（ρ）= 0.42，置信区间（CI）：0.26 - 0.56，p<0.001；ρ = 0.54，CI 0.39 - 0.65，p<0.001）。
CeD患者中存在抗GP2支持了这样一种观点，即对GP2的耐受性丧失可能是这种肠道疾病自身炎症过程的一种表现。
