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腹腔疾病患者循环中的抗下丘脑抗体:组织转谷氨酰胺酶是敌是友?

Circulating anti-hypothalamus antibodies in celiac patients: tissue transglutaminase friend or foe?

机构信息

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.

出版信息

Immunol Res. 2023 Dec;71(6):839-848. doi: 10.1007/s12026-023-09394-0. Epub 2023 May 23.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7954/10667380/e4e83383f036/12026_2023_9394_Fig1_HTML.jpg

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