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A Journal on Internal Medicine

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Panminerva Medica 1998 December;40(4):261-3


language: English

Indirect immunofluorescence for of anti-jejunum antibody detection in celiac disease: comparison among different antigenic substrates

Sategna-Guidetti C., Grosso S. B., Bruno M., Grosso S.

From the Chair of Gastroenterology Department of Internal Medicine, University of Turin, Turin, Italy


Background. Although ­anti-endo­my­sium anti­bod­ies (EmA) are the ­most reli­able ser­o­log­i­cal mark­ers of ­celiac dis­ease (CD), ­there is a ­need for low-­cost meth­ods for screen­ing pro­grams, as clin­i­cal­ly ­silent dis­ease is increas­ing­ly rec­og­nized.
Aim. To eval­u­ate the suit­abil­ity of mon­key, rat and rab­bit jeju­num as a sub­strate for the deter­mi­na­tion of ­anti-jej­u­nun anti­bod­ies (JAB) in CD.
Methods. JAB of IgA ­class ­were detect­ed by indi­rect immu­no­flu­o­res­cence on fro­zen sec­tions of jeju­num ­from mon­keys, ­white ­rats and domes­tic rab­bits. Sera ­from 61 untreat­ed ­adults ­with biop­sy-prov­en CD and EmA pos­i­tiv­ity in 57 out of 61 ­entered the ­study as ­true pos­i­tives, ­while ­sera ­from 60 con­trols ­were con­sid­ered as ­true neg­a­tives.
Results. The sec­tions of mon­key jeju­num ­showed the char­ac­ter­is­tic pat­tern of elon­gat­ed vil­lous flu­o­res­cence, a ­ring-­like pos­i­tiv­ity of the cryp­tal base­ment mem­brane, an endo­my­sium-­like flu­o­res­cence ­along the ­smooth mus­cle ­layers in the tuni­ca mus­col­ar­is, ­while per­i­cryp­tal flu­o­res­cence was not so evi­dent on rat and rab­bit jeju­num. As com­pared to EmA pos­i­tiv­ity, the prev­a­lence of JAB on mon­key, rat and rab­bit tis­sues was respec­tive­ly 57/57, 54/57, 52/57. Two ­sera ­among 4 Ema neg­a­tives ­proved pos­i­tive for JAB. No ­false pos­i­tiv­ity result­ed ­from EmA and JAB on mon­key jeju­num, ­while a low­er spec­i­fic­ity was ­found for JAB on rat and rab­bit sub­strates.
Conclusions. Although mon­key, rat and rab­bit ­small intes­tine ­appeared to be a suit­able alter­na­tive sub­strate for deter­mi­na­tion of IgA-JAB, ­because of its low­er ­cost and high­er avail­abil­ity, it can­not ­replace mon­key oesoph­a­gus, and be rec­om­mend­ed for ­wide use.

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