Jejunal immunoglobulin and antigliadin antibody secretion in adult coeliac disease.

Abstract

We compared the local intestinal immunoglobulin (Ig) secretion in six adult patients with coeliac disease and nine control subjects by perfusion of a small bowel segment under an occluding balloon and analysis ofthe perfusion fluid for the content of Ig and secretory component. The results were compared to the number of Ig-containing plasma cells in the test segment. There was, respectively, a two-

Increased mucosal synthesis of rheumatoid factor (RF) in coeliac disease

“…Furthermore, the intestinal RF production in our patients was dependent on the activity of the disease as defined by histology of the jejunal mucosa. The present findings that secretory IgA quantitatively plays the major role in mucosal immunoglobulin defence, and that the synthesis of secretory IgA and IgM is enhanced in active coeliac disease, are in accordance with previous studies [8][9][10].…”

“…The lamina propria is expanded and crowded with lymphocytes and plasma cells [1][2][3][4]. Both in vitro and in vivo studies have demonstrated an increased secretion of IgA and IgM as well as gluten-specific antibodies in the intestinal lamina propria from patients with active coeliac disease [5][6][7][8][9][10]. Antigliadin antibodies in serum represent sensitive and relatively specific serological tests for coeliac disease [11][12][13].…”

The changing immunological paradigm in coeliac disease

“…7, left) apparently explains most of the commonly increased serum IgA concentration characteristic of untreated or gluten-challenged patients [47]; a strong positive correlation exists between the serum level of IgA antibodies to gluten/gliadin and the number of jejunal IgA + PCs per tissue unit [34]. The fact that 57-61% of the circulating IgA antibodies are dimers in untreated patients [54,74], in addition to a substantial enrichment of the IgA2 antibody fraction [75], further attests to a significant mucosal origin. Alternatively, gluten/gliadin antibodies may be secreted in peripheral blood from circulating IgA + plasmablasts on their way from inductive gut-associated lymphoid tissue to seed the lamina propria [76].…”

“…The IgA antibodies were, as expected, found to be mainly of the SIgA type [54,55] and to contain a greater proportion of IgA2 than comparable antibodies in serum [56]. Moreover, the IgA antibodies were shown to disappear more slowly from intestinal fluid than from serum during gluten restriction [51], and the jejunal IgM antibodies persisted for quite prolonged periods in treated adults [55].…”

Celiac Disease: An Immunological Jigsaw

“…They are enriched in polymeric IgA and produced by intestinal plasma cells, the density of which is markedly increased in CD LP (Colombel et al, 1990;Di Niro et al, 2012). A recent study showed that 10% of IgA plasma cells isolated from the intestinal LP of untreated CD produced TG2 antibodies.…”