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Elevated serum antiphospholipid antibodies in adults with celiac disease
Outi Laine1, Katariina Pitkänen2, Katri Lindfors3
1Faculty of Medicine and Life Sciences, University of Tampere, and Department of Internal Medicine, Tampere University Hospital, Finland; Celiac Disease Research Center, University of Tampere, Finland.
Insights
Adults with celiac disease have higher levels of antiphospholipid antibodies, including anticardiolipin and antiprothrombin antibodies. This increase appears unrelated to gluten intake, suggesting a non-dietary factor in celiac disease autoimmunity.
Area of Science:
- Immunology
- Gastroenterology
- Hematology
Background:
- Celiac disease is associated with an increased risk of thrombosis.
- Antiphospholipid antibodies (aPLs) are linked to thrombotic events.
Purpose of the Study:
- To investigate serum levels of antiphospholipid antibodies in adult celiac disease patients.
- To compare antibody levels in untreated versus treated celiac disease patients.
Main Methods:
- Enzyme immunoassay testing for IgG and IgM antiphospholipid antibodies (anticardiolipin, antiprothrombin, phosphatidylserine-prothrombin).
- Analysis of 179 celiac disease patients (89 untreated, 90 treated) and 91 controls.
Main Results:
- Celiac disease patients exhibited significantly higher levels of anticardiolipin IgG, antiprothrombin IgG, and antiphosphatidylserine-prothrombin IgG compared to controls.
- Treated celiac disease patients showed higher levels of these antibodies than untreated patients.
- Disease presentation phenotype did not influence serum antiphospholipid antibody levels.
Conclusions:
- Adult celiac disease is characterized by elevated serum antiphospholipid antibodies.
- The increased antibody levels in treated patients suggest the phenomenon is not solely gluten-dependent.
- Further research is needed to elucidate the prothrombotic role of antiphospholipid antibodies in celiac disease.
Background And Aims:
An increased incidence of thrombosis is suggested in celiac disease. We explored serum levels of antiphospholipid antibodies in untreated and treated adult celiac disease patients.
Methods:
A cohort of 179 biopsy-proven celiac disease patients (89 untreated, 90 on long-term gluten-free diet) and 91 non-celiac controls underwent clinical examination, assessment of celiac serology and enzyme immunoassay testing for anticardiolipin IgG and IgM, prothrombin IgG, and phosphatidylserine-prothrombin IgG and IgM.
Results:
The level of antiphospholipid antibodies was higher in celiac disease patients compared with controls: anticardiolipin IgG 4.9 (0.7-33.8) vs 2.2 (0.4-9.6) U/ml, antiprothrombin IgG 2.9 (0.3-87.8) vs 2.1 (0.5-187.0) U/ml, antiphosphatidylserine-prothrombin IgG 6.9 (0.0-54.1) vs 2.3 (0.5-15.1) U/ml; p < 0.05 for all. Anticardiolipin IgG, antiprothrombin IgG and antiphosphatidylserine-prothrombin IgG were higher in treated compared with untreated patients. The phenotype of celiac disease at presentation (gastrointestinal symptoms, malabsorption or anemia, and extraintestinal symptoms or screen-detected disease) had no effect on the level of serum antiphospholipid antibodies.
Conclusion:
The serum level of antiphospholipid antibodies is increased in adults with celiac disease. The higher level of antibodies in treated patients suggests that the increase is not gluten-dependent. The prothrombotic role of antiphospholipid antibodies in celiac disease warrants further studies.
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