Low prevalence of IgA anti-transglutaminase 1, 2, and 3 autoantibodies in children with atopic dermatitis

Abstract

BackgroundAtopic dermatitis (AD) is a multifactorial chronic inflammatory skin disease presenting with a relapsing clinical pattern similar to chronic autoimmune disease. Several human transglutaminases have been defined and keratinocyte transglutaminase (TG1) and epidermal transglutaminase (TG3) expressed in the epidermis are associated with epidermal barrier dysfunction. Since impairments to the epidermal barrier represent an important factor in AD, we hypothesized that IgA autoantibodies specific for TG1 (IgA-anti-TG1) and TG3 (IgA-anti-TG3) may affect AD development during childhood.MethodsActive AD patients (n = 304), 28 patients with biopsy-confirmed coeliac disease (CD), 5 patients with active AD and CD, and 55 control patients without CD and skin diseases were enrolled into the study. IgA-anti-TG1 and IgA-anti-TG3 reactivity was determined using an enzyme-linked immunosorbent assay. IgA-anti-TG2 were defined using a fluoroenzyme immunoassay.ResultsIgA-anti-TG1 antibodies were found in 2% and IgA-anti-TG3 antibodies in 3% of patients with active AD. Two out of the 5 patients with AD and concomitant CD had IgA-anti-TG1 and IgA-anti-TG2 antibodies. In CD patients, 36% of individuals presented with elevated IgA-anti-TG1 antibodies and 18% presented with elevated IgA-anti-TG3 antibodies and all CD patients presented with IgA-anti-TG2 antibodies (significantly different from AD patients and controls, p < 0.05). In CD patients, IgA-anti-TG1 and/or IgA-anti-TG3 seropositivity tended to appear concurrently, whereas only one patient with AD had both types of autoantibodies.ConclusionsIgA-anti-TG1 and IgA-anti-TG3 seropositivity was rare in active AD but frequent in CD patients. The level of circulating antibodies related to skin lesions could be studied by determining the levels of IgA-anti-TG1 and IgA-anti-TG3 in skin biopsies of AD patients.

Atopic dermatitis and autoimmunity: the occurrence of autoantibodies and their association with disease severity

“…Only one study solely investigated IgA autoantibodies in AD: Ress et al [37] carried out a large case-control study, comprising 297 patients with AD and 52 healthy control subjects. ELISA techniques were used to determine the presence of IgA-anti-transglutaminase 1 (anti-TG1) and IgA-anti-transglutaminase 3 (anti-TG3) in the control group and AD group.…”

Autoantibodies Against the Immunodominant Bullous Pemphigoid Epitopes Are Rare in Patients With Dermatitis Herpetiformis and Coeliac Disease

“…Three of 12 patients with pemphigoid gestationis had an elevated level of IgA TG2 autoantibodies and one had a high IgA TG3 autoantibody level (35). Anti-TG3 IgA antibodies have also been found in 3% of patients with atopic dermatitis (n = 300), but the significance of this finding is not known (36). Taken together, our current results based on the commercially available BP180, TG2, and TG3 ELISA tests do not support the idea that epitope spreading explains the evolution from DH or CD into BP.…”

Serum transglutaminase 3 antibodies correlate with age at celiac disease diagnosis

“…However, majority of studies focusing on serum TG3 antibodies have been centered around DH patients, and more limited data are available about TG3 antibodies in celiac disease. Correlations between TG3 and TG2 antibodies in celiac disease have been detected in some [27,29] but not in all studies [11]. Borroni et al [19] published a study showing correlation between TG3 antibody titers and weight loss; no correlation was detected between TG3 antibodies and villous atrophy, age at celiac disease diagnosis, associated diseases or the presence of complications.…”