Vainio E, Kosnai I, Hällström O, Karpati S, Mäki M, Reunala T
J Pediatr Gastroenterol Nutr. 1986 Sep-Oct;5(5):735-9. doi: 10.1097/00005176-198609000-00012.
The serum samples of 27 children with dermatitis herpetiformis (DH) were examined for the presence of antigliadin (AGA) and antireticulin (ARA) antibodies. AGA were determined with an enzyme-linked immunosorbent assay (ELISA) and ARA with an immunofluorescence method. Increased IgA or IgG class AGA levels were found in four of ten children on a normal diet, in two of 25 on a gluten-free diet (GFD), and in two of four children on gluten challenge. The corresponding figures for ARA were nine of ten, two of 25, and four of four, respectively. All nine patients with ARA on a normal diet had either subtotal or partial villous atrophy, whereas the patient negative for ARA had a normal jejunal mucosa. ARA were mostly of IgA class, and after gluten withdrawal, increased levels fell to normal range. Four children were challenged with gluten, and they all developed subtotal villous atrophy and demonstrated IgA class ARA. These results suggest that in childhood DH, ARA is a more sensitive indicator of gluten-sensitive enteropathy than AGA, but both antibody determinations can be used in monitoring adherence to GFD treatment.
对27例疱疹样皮炎（DH）患儿的血清样本进行了抗麦醇溶蛋白（AGA）和抗网硬蛋白（ARA）抗体检测。采用酶联免疫吸附测定（ELISA）法检测AGA，采用免疫荧光法检测ARA。在正常饮食的10名儿童中，4名儿童的AGA IgA或IgG类水平升高；在无麸质饮食（GFD）的25名儿童中，2名儿童升高；在麸质激发试验的4名儿童中，2名儿童升高。ARA的相应数字分别为10名中的9名、25名中的2名和4名中的4名。正常饮食时所有9例ARA阳性患者均有部分或完全绒毛萎缩，而ARA阴性患者空肠黏膜正常。ARA大多为IgA类，戒麸质后升高水平降至正常范围。4名儿童接受麸质激发试验，均出现部分绒毛萎缩并显示IgA类ARA。这些结果表明，在儿童DH中，ARA是比AGA更敏感的麸质敏感性肠病指标，但两种抗体检测均可用于监测对GFD治疗的依从性。
