Antibodies to gluten and reticulin in gastrointestinal diseases

Abstract

Antibodies to reticulin were found in 33% of coeliac patients on a normal diet. These antibodies were found in only 11% of coeliac patients on a gluten-free diet. In patients with dermatitis herpitiformis, 12% had these antibodies, whereas the highest frequency in the other diseases studied (Crohn's disease, ulcerative colitis, cystic fibrosis and `recurrent diarrhoea') was 7% (compared to 2% in healthy controls).

Antibodies to gluten, demonstrated with the immunofluorescence technique, were found in all coeliac children on a normal diet that were studied, and in half of the adults with the untreated disease. In children and adults on a gluten-free diet these frequencies decreased to 87 and 32%. In Crohn's disease, cystic fibrosis, recurrent diarrhoea, dermatitis herpetiformis and ulcerative colitis, the frequencies were 52, 42, 37, 18 and 18%, respectively (and in 4% of controls).

It was therefore concluded that antibodies to gluten were sensitive markers for gastrointestinal diseases, but were not specific for gluten enteropathy. Antibodies to reticulin, on the other hand, were less sensitive but of far greater specificity for coeliac disease. Gluten antibodies were of the IgA, IgM and IgG classes, whereas antibodies to reticulin were only of the IgA and IgG classes. Both types of antibody were found to be non-complement-fixing. Autoantibodies to smooth muscle were found in 5% of the coeliac patients (and in 0% of controls). No relationship with hepatic complications was found. In the patients with dermatitis herpetiformis, autoantibodies to gastric parietal cells were found in 24% (and in 5% of controls). No relationship was established between the occurrence of HLA-B8 and the presence or absence of any of the antibodies studied.