Patients with coeliac disease have a characteristic gliadin antibody pattern

By use of an immunoblotting technique we have investigated the specificity of circulating IgG antibodies with respect to reactions with the alpha-, beta-, gamma- and omega-fractions of gliadin in patients with coeliac disease and in patients with diarrhoea of other causes. Untreated coeliac patients show a characteristic reactivity against polypeptides in the gamma-fraction, with an Mr of 35 and 45 kilodaltons, but only minor reactivity against the other fractions. One coeliac patient exclusively had antibodies to a 80 kilodalton component. Such a reaction pattern was not observed in other groups of patients with diarrhoea, as they had only weak reactions against the gamma-fraction but a stronger reaction against the other fractions. This might indicate that enterocytes of coeliac patients specifically take up distinct polypeptides of gamma-gliadin and by transcellular transport present them to immunocompetent cells. The results also suggest that there are distinct components of gliadin that provoke symptoms in different coeliac patients, indicating a heterogenecity of the disease. The study might lead to new diagnostic methods and to elucidation of the pathogenetic mechanisms behind coeliac disease.