Anti-parietal cell antibodies and pernicious anemia in patients with type 1 diabetes mellitus and multiethnic background

Pinto, Alinna Lage Ferraz; Dantas, Joana Rodrigues; Araújo, Dorothy Sue Dunn de; Barone, Bianca; Papi, José Ângelo de Souza; Oliveira, José Egídio Paulo de; Zajdenverg, Lenita; Rodacki, Melanie

doi:10.1016/j.diabres.2013.08.008

Cited by 10 publications

(7 citation statements)

References 10 publications

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“…We determined ATP4A antibodies are present in 17% of children with T1D with no additional autoimmune diseases. Earlier studies concerning pediatric T1D patients revealed APCA in up to 7% of patients; however, the measurements were based on protocols using ELISA . This disparity with our findings may result from the higher sensitivity of the novel RIA detecting ATP4A autoantibodies utilized in this study .…”

Section: Discussioncontrasting

confidence: 94%

“…APCA targeting the gastric proton pump, the H+/K+ ATPase, measured by enzyme‐linked immunosorbent assay (ELISA) are more frequent among T1D subjects than in the healthy population and more common in adults (13%‐20%) than in children (5%) . In our previous work, using a more sensitive radioimmunoprecipitation assay (RIA) detecting autoantibodies against the 4A subunit of the gastric proton pump (ATP4A), we found ATP4A positivity in 30% of children with T1D and a female preponderance, confirmed in a more recent study …”

Section: Introductionsupporting

confidence: 61%

“…Gastric autoimmunity and related increased risk of AG is predicted to be more common in T1D individuals, especially in adult patients . We determined ATP4A antibodies are present in 17% of children with T1D with no additional autoimmune diseases.…”

Section: Discussionmentioning

confidence: 99%

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ATP4A autoimmunity in pediatric patients with type 1 diabetes and its relationship to blood count, iron metabolism, and vitamin B12

Chobot¹,

Rusak

Wenzlau

et al. 2017

Pediatr Diabetes

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Objective: We aimed to assess the prevalence of autoantibodies against the 4A subunit of the gastric proton pump (ATP4A) in pediatric type 1 diabetes (T1D) patients and explore the relationship between ATP4A positivity and blood cell count, iron turnover, and vitamin B12 concentration. Subjects:The study included 94 (59% female) T1D children (aged 12.5 AE 4.1 years, T1D duration 4.2 AE 3.6 years, HbA1c 7.3 AE 1.5% (57 AE 12.6 mmol/mol) with no other autoimmune diseases.Methods: ATP4A antibodies were measured in T1D patients using a radioimmunoprecipitation assay. Blood cell count, iron concentration, total iron binding capacity, ferritin, transferrin, hepcidin, and vitamin B12 concentration were measured in all the study participants.Results: A total of 16 (17%) children were ATP4A positive. Serum concentrations of ferritin were significantly lower in ATP4A positive than in antibody negative subjects (P = .034). Overall the levels of ATP4A antibodies (ATP4A Index) correlated positively with the age at T1D diagnosis (r = 0.228, P = .026) and negatively with ferritin levels (r = −0.215, P = .037). In ATP4A positive patients, the ATP4A Index correlated positively with age at diagnosis (r = 0.544, P = .032) and negatively with vitamin B12 levels (r = −0.685, P = .004).Conclusions: ATP4A antibodies were present in a significant proportion of children with T1D.Higher ATP4A levels in T1D children are associated with lower, yet still fitting within the normal range, levels of vitamin B12, and ferritin. Routine screening of T1D children for gastric autoimmunity (ATP4A) should be considered with follow-up of those positive for vitamin B12 and iron deficiency. K E Y W O R D SATP4A antibodies, ferritin, gastric autoimmunity, type 1 diabetes, vitamin B12

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Section: Discussioncontrasting

confidence: 94%

Section: Introductionsupporting

confidence: 61%

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ATP4A autoimmunity in pediatric patients with type 1 diabetes and its relationship to blood count, iron metabolism, and vitamin B12

Chobot¹,

Rusak

Wenzlau

et al. 2017

Pediatr Diabetes

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“…The clinical spectrum of CAG is often not clearly defined ( 37 ), with symptoms including more frequent long-standing dyspepsia ( 38 ), mainly postprandial fullness ( 39 ), and deficiencies of erythropoietic micronutrients potentially leading to anemia ( 6 , 40 , 41 ). Currently, the serum PCAs are generally used for the noninvasive diagnostics of autoimmune gastritis, especially in patients with other autoimmune disorders ( 9 , 17 – 20 ). Neither current guidelines ( 4 , 6 ) nor physicians in clinical practice routinely use PCA as a serological screening tool to identify patients with CAG.…”

Section: Discussionmentioning

confidence: 99%

Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis

Lahner¹,

Marzinotto

Lampasona

et al. 2020

Clinical and Translational Gastroenterology

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INTRODUCTION: Noninvasive assessment of corpus atrophic gastritis (CAG), a condition at increased risk of gastric cancer, is based on the measurement of pepsinogens, gastrin, and Helicobacter pylori antibodies. Parietal cell autoantibodies (PCAs) against the gastric proton pump (ATP4) are potential serological biomarkers of CAG. The purpose of this study was to compare the diagnostic performance of PCA and pepsinogen I tests in patients with clinical suspicion of CAG with the histopathological evaluation of gastric biopsies as reference standard. METHODS: A prospective case-finding study was performed on 218 naive adult patients (131 women, median age 65 years) who underwent gastric biopsies to confirm/exclude CAG. Patients with histopathological CAG were defined as cases, conversely as controls. Autoantibodies against the individual alpha (ATP4A) and beta (ATP4B) subunits of ATP4 were measured by luciferase immunoprecipitation, and global PCA and pepsinogen I by enzyme-linked immunosorbent assay. RESULTS: Histopathology classified 107 subjects (49%) as cases (CAG+, autoimmune 81.2%, and multifocal extensive 18.8%) and 111 subjects (51%) as controls (CAG−). In cases, ATP4A, ATP4B, and PCA titers were increased compared with controls, whereas pepsinogen I was reduced ( P < 0.0001 for all). ATP4B, ATP4A, and pepsinogen I tests showed sensitivities of 77%, 75%, and 73% and specificities of 88%, 88%, and 80%, respectively. The receiver operating characteristic (ROC) area under the ROC curve (AUC) of these serological biomarkers confirmed their ability to discriminate cases from controls (ATP4B = 0.838, ATP4A = 0.826, pepsinogen I = 0.775, and PCA = 0.805), whereas the partial ROC-pAUC 90 analysis showed that the ATP4B test had the best diagnostic performance ( P = 0.008 vs ATP4; P = 0.0002 vs pepsinogen I). The presence of autoimmune or extensive gastritis was not significantly different between ATP4B positive or negative cases ( P = 0.217). DISCUSSION: PCAs are promising serological biomarkers for the identification of CAG in high-risk individuals, particularly in an autoimmune pattern but also in an extensive-multifocal atrophy pattern.

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“…It was also observed that, autoimmunity against gastric parietal cells was associated with other autoimmune diseases. 56 It was also observed that, APC antibody positive patients, especially who are hypergastrenemic, are a high-risk group for pre malignant lesions and APC antibodies and PA screening was proposed in all patients with T1DM. 55 Kakleas et al, 57 reported that at baseline 7.22% of patients with T1DM had APC antibody and at follow-up, 7.21% had these antibodies.…”

Section: Anti Parietal Cell Antibodies and Pernicious Anaemiamentioning

confidence: 99%

Organ specific autoimmune disorders in type 1 diabetes mellitus

Ashok¹,

Sachan²

2017

jcsr

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Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease that results in absolute insulin deficiency due to destruction of the pancreatic beta cells. It is frequently associated with other autoimmune diseases like autoimmune thyroid (AIT) disease, celiac disease (CD), Addison's disease (AD), and vitiligo. These diseases, including T1DM are associated with organ specific autoantibodies. These autoantibodies are important as diagnostic markers and detectable antibodies may precede the clinical onset of the disease. These diseases usually occur together in same patient and have shared genetic predisposition. These autoimmune diseases can severely affect clinical management of T1DM. It is possible to screen for these associated diseases by testing for relevant autoantibodies. Earlier detection of organ specific autoimmunity will enable physicians to treat these diseases at an initial stage and can prevent development of fullblown clinical condition.

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Anti-parietal cell antibodies and pernicious anemia in patients with type 1 diabetes mellitus and multiethnic background

Cited by 10 publications

References 10 publications

ATP4A autoimmunity in pediatric patients with type 1 diabetes and its relationship to blood count, iron metabolism, and vitamin B12

ATP4A autoimmunity in pediatric patients with type 1 diabetes and its relationship to blood count, iron metabolism, and vitamin B12

Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis

Organ specific autoimmune disorders in type 1 diabetes mellitus

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