Associação entre marcadores sorológicos de doença celíaca e das doenças autoimunes da tireóide

Abstract

RESUMODoença celíaca (DC) é uma doença autoimune do intestino delgado com importante associação com HLA-DQ2 e DQ8. Tem o glúten como fator etiológico e a enzima transglutaminase (TGase) tecidual como autoantígeno. A DC é associada a outras doenças autoimunes como diabetes mellitus tipo 1, lupus eritematoso sistêmico, artrite reumatóide, síndrome de Sjögren e doenças autoimunes da tireóide. O objetivo deste estudo foi investigar a ocorrência de anticorpos séricos da classe Celiac disease (CD) is an autoimmune disease of the small bowel characterized by a strong genetic association with HLA -DQ2 and DQ8. Gluten is the etiological factor and the tissue enzyme transglutaminase (TGase) is its autoantigen. CD is associated with several autoimmune diseases such as type 1 diabetes, systemic lupus erythematous, rheumatoid arthritis, Sjögren's syndrome and autoimmune thyroid diseases. The aim of this study was to investigate the occurrence of serum IgA anti-endomysial and anti-human TGase antibodies in individuals with positive anti-thyroid antibody (ATA). The concordance between these two tests was also evaluated. Anti-endomysial antibodies were positive in 10 out of 456 (2.2%) and anti-human TGase were positive in 14 of 454 (3.1%) individuals with positive ATA. In control subjects they were positive in 1 of 197 (0.5%) and 2 of 198 (1%) for anti-endomysial and anti-human tissue TGase antibodies, respectively. The odds ratio (OR) for the anti-endomysial antibodies was 4.42 and for the antihuman TGase 3.12 in individuals with ATA when compared with controls. An elevated concordance index (k= 0.84) was observed between anti-endomisyal antibodies and anti-human TGase. We conclude that

Celiac Disease and Imbalance of Intestinal Flora

“…As malignant complications, of a more serious character, we can highlight lymphoma in the small intestine, carcinoma of the esophagus and pharynx, as well as adenocarcinoma of the small intestine whose etiopathogenesis is little elucidated [10,13,30]. In addition to these complications, CD is being correlated with several autoimmune diseases, including type I diabetes, Down syndrome and Turner syndrome [11,[31][32][33]. In case of persistent inadequate diet, symptoms of gluten intolerance persist and lead to disorders that also affect the intestinal flora, which consists of an important set of microorganisms that co-exist with humans and participate in important metabolic functions, in addition to exert an indispensable function of defending the organism against pathogens by preventing external microorganisms or even the microbiota itself from causing infections [34,35].…”

Major Considerations of Celiac Disease: A Narrative Review

“…Also, Melo (2005) understands celiac disease as an autoimmune disease of the small intestine, with gluten as the main responsible for the pathogenesis, with the tissue transglutaminase enzyme as the role of the autoantigen. Also, according to the author, this pathology is linked to several other autoimmune diseases, such as, for example, Systemic Lupus Erythematosus, Type 1 Diabetes Mellitus, Rheumatoid Arthritis, Autoimmune Thyroid Diseases and Sjögren's Syndrome [13].…”

Doença Celíaca: Sintomas, Diagnóstico e Tratamento Nutricional

“…A frequência da DC nos pacientes com doenças autoimunes da tireóide (DAT) tem se mostrado de quatro a oito vezes maior do que na população geral ou em doadores de sangue. 5 O diagnóstico dessa doença baseia--se em testes sorológicos (antiendomisial, antigliadina e anticorpos de antitransglutaminase) e em mudanças nas características histopatológicas (as vilosidades se atrofiam, hiperplasia das criptas e células inflamatórias infiltradas) visto em biópsia de duodenal distal, teste padrão para o diagnóstico da DC. 6 De acordo com os critérios da Sociedade Européia e Latino--Americana, há necessidade de realizar três biópsias para fornecer o diagnóstico, sendo que a primeira delas revela atrofia vilositária, a segunda, logo após o tratamento que demonstra a recuperação das vilosidades e criptas, e a terceira e última que mostra um dano induzido pela dieta com glúten.…”