Ann Dermatol.  2013 Aug;25(3):298-303. 10.5021/ad.2013.25.3.298.

Coeliac Disease-Associated Antibodies in Psoriasis

• Akbulut S
• Gur G
• Topal F
• Senel E
• Topal FE
• Alli N
• Saritas U

• KMID: 2265868
• DOI: http://doi.org/10.5021/ad.2013.25.3.298

Abstract

BACKGROUND
The possible relationship between psoriasis and coeliac disease (CD) has been attributed to the common pathogenic mechanisms of the two diseases and the presence of antigliadin antibodies in patients has been reported to increase the incidence of CD.
OBJECTIVE
The aim of this report was to study CD-associated antibodies serum antigliadin antibody immunoglobulin (Ig)A, IgG, anti-endomysial antibody IgA and anti-transglutaminase antibody IgA and to demonstrate whether there is an increase in the frequency of those markers of CD in patients with psoriasis.
METHODS
Serum antigliadin antibody IgG and IgA, antiendomysial antibody IgA and anti-transglutaminase antibody IgA were studied in 37 (19 males) patients with psoriasis and 50 (23 males) healthy controls. Upper gastrointestinal endoscopy and duodenal biopsies were performed in patients with at least one positive marker.
RESULTS
Antigliadin IgA was statistically higher in the psoriasis group than in the controls (p<0.05). Serological markers were found positive in 6 patients with psoriasis and 1 person from the control group. Upper gastrointestinal endoscopy was performed in all these persons, with biopsies collected from the duodenum. The diagnosis of CD was reported in only one patient with psoriasis following the pathological examination of the biopsies. Whereas one person of the control group was found to be positive for antigliadin antibody IgA, pathological examination of the duodenal biopsies obtain from this patient were found to be normal.
CONCLUSION
Antigliadin IgA prominently increases in patients diagnosed with psoriasis. Patients with psoriasis should be investigated for latent CD and should be followed up.

Keyword

Antibodies; Celiac disease; Duodenum; Psoriasis

MeSH Terms

Antibodies
Biopsy
Celiac Disease
Duodenum
Endoscopy, Gastrointestinal
Humans
Immunoglobulin A
Immunoglobulin G
Immunoglobulins
Incidence
Psoriasis
Antibodies
Immunoglobulin A
Immunoglobulin G
Immunoglobulins

Reference

1. Dieterich W, Storch WB, Schuppan D. Serum antibodies in celiac disease. Clin Lab. 2000; 46:361–364.

2. Capristo E, Addolorato G, Mingrone G, De Gaetano A, Greco AV, Tataranni PA, et al. Changes in body composition, substrate oxidation, and resting metabolic rate in adult celiac disease patients after a 1-y gluten-free diet treatment. Am J Clin Nutr. 2000; 72:76–81.

3. Hutchinson JM, Robins G, Howdle PD. Advances in coeliac disease. Curr Opin Gastroenterol. 2008; 24:129–134.

4. Rostom A, Murray JA, Kagnoff MF. American gastroenterological association (AGA) Institute technical review on the diagnosis and management of celiac disease. Gastroenterology. 2006; 131:1981–2002.

5. Dieterich W, Storch WB, Schuppan D. Serum antibodies in celiac disease. Clin Lab. 2000; 46:361–364.

6. Bürgin-Wolff A, Hadziselimovic F. Screening test for coeliac disease. Lancet. 1997; 349:1843–1844.

7. Agréus L, Svärdsudd K, Tibblin G, Lavö B. Endomysium antibodies are superior to gliadin antibodies in screening for coeliac disease in patients presenting supposed functional gastrointestinal symptoms. Scand J Prim Health Care. 2000; 18:105–110.

8. Sblattero D, Berti I, Trevisiol C, Marzari R, Tommasini A, Bradbury A, et al. Human recombinant tissue transglutaminase ELISA: an innovative diagnostic assay for celiac disease. Am J Gastroenterol. 2000; 95:1253–1257.

9. Kirby B, Griffiths CE. Novel immune-based therapies for psoriasis. Br J Dermatol. 2002; 146:546–551.

10. Ojetti V, Aguilar Sanchez J, Guerriero C, Fossati B, Capizzi R, De Simone C, et al. High prevalence of celiac disease in psoriasis. Am J Gastroenterol. 2003; 98:2574–2575.

11. Baker BS, Swain AF, Griffiths CE, Leonard JN, Fry L, Valdimarsson H. Epidermal T lymphocytes and dendritic cells in chronic plaque psoriasis: the effects of PUVA treatment. Clin Exp Immunol. 1985; 61:526–534.

12. Mailliard RB, Egawa S, Cai Q, Kalinska A, Bykovskaya SN, Lotze MT, et al. Complementary dendritic cell-activating function of CD8+ and CD4+ T cells: helper role of CD8+ T cells in the development of T helper type 1 responses. J Exp Med. 2002; 195:473–483.

13. Veal CD, Capon F, Allen MH, Heath EK, Evans JC, Jones A, et al. Family-based analysis using a dense single-nucleotide polymorphism-based map defines genetic variation at PSORS1, the major psoriasis-susceptibility locus. Am J Hum Genet. 2002; 71:554–564.

14. Michaëlsson G, Gerdén B, Hagforsen E, Nilsson B, Pihl-Lundin I, Kraaz W, et al. Psoriasis patients with antibodies to gliadin can be improved by a gluten-free diet. Br J Dermatol. 2000; 142:44–51.

15. Woo WK, McMillan SA, Watson RG, McCluggage WG, Sloan JM, McMillan JC. Coeliac disease-associated antibodies correlate with psoriasis activity. Br J Dermatol. 2004; 151:891–894.

16. Cardinali C, Degl'innocenti D, Caproni M, Fabbri P. Is the search for serum antibodies to gliadin, endomysium and tissue transglutaminase meaningful in psoriatic patients? Relationship between the pathogenesis of psoriasis and coeliac disease. Br J Dermatol. 2002; 147:187–188.

17. Collin P, Reunala T. Recognition and management of the cutaneous manifestations of celiac disease: a guide for dermatologists. Am J Clin Dermatol. 2003; 4:13–20.

18. Marsh MN, Crowe PT. Morphology of the mucosal lesion in gluten sensitivity. Baillieres Clin Gastroenterol. 1995; 9:273–293.

19. Green PH, Cellier C. Celiac disease. N Engl J Med. 2007; 357:1731–1743.

20. Rubio-Tapia A, Murray JA. Celiac disease beyond the gut. Clin Gastroenterol Hepatol. 2008; 6:722–723.

21. Kamaeva OI, Reznikov IuP, Pimenova NS, Dobritsyna LV. Antigliadin antibodies in the absence of celiac disease. Klin Med (Mosk). 1998; 76:33–35.

22. Birkenfeld S, Dreiher J, Weitzman D, Cohen AD. Coeliac disease associated with psoriasis. Br J Dermatol. 2009; 161:1331–1334.

23. Ventura A, Magazzù G, Greco L. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. Gastroenterology. 1999; 117:297–303.

24. Hendel L, Hendel J, Johnsen A, Gudmand-Høyer E. Intestinal function and methotrexate absorption in psoriatic patients. Clin Exp Dermatol. 1982; 7:491–497.

25. Damasiewicz-Bodzek A, Wielkoszyński T. Serologic markers of celiac disease in psoriatic patients. J Eur Acad Dermatol Venereol. 2008; 22:1055–1061.

26. Michaëlsson G, Gerdén B, Ottosson M, Parra A, Sjöberg O, Hjelmquist G, et al. Patients with psoriasis often have increased serum levels of IgA antibodies to gliadin. Br J Dermatol. 1993; 129:667–673.

27. Lindqvist U, Rudsander A, Boström A, Nilsson B, Michaölsson G. IgA antibodies to gliadin and coeliac disease in psoriatic arthritis. Rheumatology (Oxford). 2002; 41:31–37.

28. Abenavoli L, Leggio L, Ferrulli A, Vonghia L, Gasbarrini G, Addolorato G. Association between psoriasis and coeliac disease. Br J Dermatol. 2005; 152:1393–1394.

29. Addolorato G, Parente A, de Lorenzi G, Dangelo Di, Abenavoli L, Leggio L, et al. Rapid regression of psoriasis in a coeliac patient after gluten-free diet. A case report and review of the literature. Digestion. 2003; 68:9–12.

30. Howard MR, Turnbull AJ, Morley P, Hollier P, Webb R, Clarke A. A prospective study of the prevalence of undiagnosed coeliac disease in laboratory defined iron and folate deficiency. J Clin Pathol. 2002; 55:754–757.

31. Bajaj-Elliott M, Poulsom R, Pender SL, Wathen NC, MacDonald TT. Interactions between stromal cell--derived keratinocyte growth factor and epithelial transforming growth factor in immune-mediated crypt cell hyperplasia. J Clin Invest. 1998; 102:1473–1480.

32. Michaëlsson G, Kraaz W, Hagforsen E, Pihl-Lundin I, Lööf L, Scheynius A. The skin and the gut in psoriasis: the number of mast cells and CD3+ lymphocytes is increased in noninvolved skin and correlated to the number of intraepithelial lymphocytes and mast cells in the duodenum. Acta Derm Venereol. 1997; 77:343–346.

33. Bazex A, Gaillet L, Bazex J. Gluten-free diet and psoriasis. Ann Dermatol Syphiligr (Paris). 1976; 103:648–650.

34. Cottafava F, Cosso D. Psoriatic arthritis and celiac disease in childhood. A case report. Pediatr Med Chir. 1991; 13:431–433.

35. Kia KF, Nair RP, Ike RW, Hiremagalore R, Elder JT, Ellis CN. Prevalence of antigliadin antibodies in patients with psoriasis is not elevated compared with controls. Am J Clin Dermatol. 2007; 8:301–305.