Limits...
Clinical and immunological relevance of anti-neuronal antibodies in celiac disease with neurological manifestations.

Caio G, De Giorgio R, Venturi A, Giancola F, Latorre R, Boschetti E, Serra M, Ruggeri E, Volta U - Gastroenterol Hepatol Bed Bench (2015)

Bottom Line: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them.NA to CNS and ENS were found in 7% and 5% of controls, respectively.High titer NA to ENS are associated with severe constipation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Surgical Sciences, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy.

ABSTRACT

Aim: To assess anti-neuronal antibodies (NA) prevalence and their correlation with neurological disorders and bowel habits in celiac disease (CD) patients.

Background: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them. Little is known about the clinical and immunological features in CD patients with neurological manifestations.

Patients and methods: NA to CNS and ENS were investigated in 106 CD patients and in 60 controls with autoimmune disorders by indirect immunofluorescence on rat / primate cerebellar cortex and intestinal (small and large bowel) sections.

Results: IgG NA to CNS (titer 1:50 - 1:400) were positive in 23 celiacs (21%), being more frequently detected in those with neurological disorders that in those without neurological dysfunction (49% vs. 8%, P< 0.0001). Of the 26 celiacs (24%) with IgG NA to ENS, 11 out of 12 with an antibody titer > 1:200 had severe constipation. Only one patient with cerebellar ataxia and intestinal sub-occlusion was positive for NA to CNS and ENS. NA to CNS and ENS were found in 7% and 5% of controls, respectively.

Conclusion: In CD the positivity of NA to CNS can be regarded as a marker of neurological manifestations. High titer NA to ENS are associated with severe constipation. The demonstration of NA to CNS and ENS suggests an immune-mediated pathogenesis leading to central neural impairment as well as gut dysfunction (hence constipation), respectively.

No MeSH data available.


Related in: MedlinePlus

Correlation between antibody titer of NA to ENS and severe constipation: 11 of 12 CD patients with antibody titer > 1:200 showed severe constipation (P< 0.0001, two-tailed Fisher’s exact test). Abbreviations: "ENS titre" refers to titer of NA to ENS.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4403027&req=5

Figure 6: Correlation between antibody titer of NA to ENS and severe constipation: 11 of 12 CD patients with antibody titer > 1:200 showed severe constipation (P< 0.0001, two-tailed Fisher’s exact test). Abbreviations: "ENS titre" refers to titer of NA to ENS.

Mentions: NA to ENS were positive in 26 (24%) of the 106 CD patients vs. 3 (5%) of the 60 controls with autoimmune disorders (P< 0.05) (Figure 5). NA to ENS were not significantly different in neurological vs. non-neurological CD, being positive in 9 (26%) of the 35 vs. 17 (24%) of the 71 patients, respectively. A high antibody titre (> 1:200) of NA to ENS was detected in 12 (46%) of the 26 CD patients and, notably, 11 of these 12 complained of severe, Rome III-defined constipation (P< 0.0001) (Figure 6). Only one patient with cerebellar ataxia and recurrent intestinal sub-occlusive episodes was positive for NA to CNS and ENS.


Clinical and immunological relevance of anti-neuronal antibodies in celiac disease with neurological manifestations.

Caio G, De Giorgio R, Venturi A, Giancola F, Latorre R, Boschetti E, Serra M, Ruggeri E, Volta U - Gastroenterol Hepatol Bed Bench (2015)

Correlation between antibody titer of NA to ENS and severe constipation: 11 of 12 CD patients with antibody titer > 1:200 showed severe constipation (P< 0.0001, two-tailed Fisher’s exact test). Abbreviations: "ENS titre" refers to titer of NA to ENS.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4403027&req=5

Figure 6: Correlation between antibody titer of NA to ENS and severe constipation: 11 of 12 CD patients with antibody titer > 1:200 showed severe constipation (P< 0.0001, two-tailed Fisher’s exact test). Abbreviations: "ENS titre" refers to titer of NA to ENS.
Mentions: NA to ENS were positive in 26 (24%) of the 106 CD patients vs. 3 (5%) of the 60 controls with autoimmune disorders (P< 0.05) (Figure 5). NA to ENS were not significantly different in neurological vs. non-neurological CD, being positive in 9 (26%) of the 35 vs. 17 (24%) of the 71 patients, respectively. A high antibody titre (> 1:200) of NA to ENS was detected in 12 (46%) of the 26 CD patients and, notably, 11 of these 12 complained of severe, Rome III-defined constipation (P< 0.0001) (Figure 6). Only one patient with cerebellar ataxia and recurrent intestinal sub-occlusive episodes was positive for NA to CNS and ENS.

Bottom Line: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them.NA to CNS and ENS were found in 7% and 5% of controls, respectively.High titer NA to ENS are associated with severe constipation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Surgical Sciences, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy.

ABSTRACT

Aim: To assess anti-neuronal antibodies (NA) prevalence and their correlation with neurological disorders and bowel habits in celiac disease (CD) patients.

Background: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them. Little is known about the clinical and immunological features in CD patients with neurological manifestations.

Patients and methods: NA to CNS and ENS were investigated in 106 CD patients and in 60 controls with autoimmune disorders by indirect immunofluorescence on rat / primate cerebellar cortex and intestinal (small and large bowel) sections.

Results: IgG NA to CNS (titer 1:50 - 1:400) were positive in 23 celiacs (21%), being more frequently detected in those with neurological disorders that in those without neurological dysfunction (49% vs. 8%, P< 0.0001). Of the 26 celiacs (24%) with IgG NA to ENS, 11 out of 12 with an antibody titer > 1:200 had severe constipation. Only one patient with cerebellar ataxia and intestinal sub-occlusion was positive for NA to CNS and ENS. NA to CNS and ENS were found in 7% and 5% of controls, respectively.

Conclusion: In CD the positivity of NA to CNS can be regarded as a marker of neurological manifestations. High titer NA to ENS are associated with severe constipation. The demonstration of NA to CNS and ENS suggests an immune-mediated pathogenesis leading to central neural impairment as well as gut dysfunction (hence constipation), respectively.

No MeSH data available.


Related in: MedlinePlus