Department of Experimental Medicine, University of Genoa, Via De Toni, 14, 16132, Genova, Italy.
Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, 16132, Genova, Italy.
Immunol Res. 2023 Dec;71(6):839-848. doi: 10.1007/s12026-023-09394-0. Epub 2023 May 23.
Celiac disease (CD) is an autoimmune disease with inflammatory characteristics, having a condition of chronic malabsorption, affecting approximately 1% of the population at any age. In recent years, a concrete correlation between eating disorders and CD has emerged. Hypothalamus plays a central role in determining eating behaviour, regulating appetite and, consequently, food intake. One hundred and ten sera from celiac patients (40 active and 70 following a gluten-free diet) were tested for the presence of autoantibodies against primate hypothalamic periventricular neurons by immunofluorescence and by a home-made ELISA assay. In addition, ghrelin was measured by ELISA. As control, 45 blood serums from healthy age matched were analysed. Among active CD, all patients resulted positive for anti-hypothalamus autoantibodies and sera showed significantly higher levels of ghrelin. All of the free-gluten CD were negative for anti-hypothalamus autoantibodies and had low levels of ghrelin, as well as healthy controls. Of interest, anti-hypothalamic autoantibodies directly correlate with anti-tTG amounts and with mucosal damage. In addition, competition assays with recombinant tTG showed a drastically reduction of anti-hypothalamic serum reactivity. Finally, ghrelin levels are increased in CD patients and correlated with anti-tTG autoantibodies and anti-hypothalamus autoantibodies. This study demonstrates for the first time the presence of anti-hypothalamus antibodies and their correlation with the severity of the CD. It also allows us to hypothesize the role of tTG as a putative autoantigen expressed by hypothalamic neurons.
乳糜泻(CD)是一种具有炎症特征的自身免疫性疾病,存在慢性吸收不良的情况,任何年龄段的人群发病率约为 1%。近年来,人们发现饮食失调与 CD 之间存在明确的相关性。下丘脑在决定进食行为、调节食欲以及相应地调节食物摄入方面起着核心作用。我们通过免疫荧光和自制 ELISA 检测,对 110 例乳糜泻患者(40 例活动期和 70 例接受无麸质饮食)血清中的抗灵长类动物下丘脑室周神经元自身抗体进行了检测。此外,还通过 ELISA 检测了胃饥饿素。作为对照,我们对 45 例来自年龄匹配的健康者的血清进行了分析。在活动期 CD 患者中,所有患者的抗下丘脑自身抗体均呈阳性,且血清中的胃饥饿素水平显著升高。所有接受无麸质饮食的 CD 患者的抗下丘脑自身抗体均为阴性,且胃饥饿素水平较低,与健康对照组相似。有趣的是,抗下丘脑自身抗体与抗 tTG 量和黏膜损伤直接相关。此外,用重组 tTG 进行的竞争检测显示抗下丘脑血清反应性明显降低。最后,CD 患者的胃饥饿素水平升高,并与抗 tTG 自身抗体和抗下丘脑自身抗体相关。本研究首次证明了抗下丘脑抗体的存在及其与 CD 严重程度的相关性。它还使我们假设 tTG 可能作为下丘脑神经元表达的一种自身抗原发挥作用。