Elevated level of IgA gliadin antibodies in patients with rheumatoid arthritis

The possibility that dietary antigens contribute to the pathogenesis of rheumatoid arthritis (RA) has been proposed. Moreover, occasional patients have been described in whom coeliac disease and RA coincide. Furthermore, most RA patients are treated with non-steroidal anti-inflammatory drugs (NSAIDs), which are known to increase gut permeability. For these reasons antibodies against gliadin were measured in a group of 43 patients with rheumatoid arthritis (RA) and a group of 43 age- and sex-matched controls. The median IgA antigliadin ELISA index was 7.1 (range 2.1-22.4) for the RA group and 3.1 (range 0.3-34.9) for the controls (p = 0.0001). The median IgG and IgM antigliadin indexes for the RA group didn't differ significantly from those of the controls. In the RA group, the level of antigliadin antibodies did not correlate with the daily dose of NSAIDs. The elevated IgA antigliadin titre in the RA group might be ascribed to the use of NSAIDs, which are harmful to the gut, but the immunological trigger effect of gluten cannot be ruled out.