The great majority of children with type 1 diabetes produce and deposit anti-tissue transglutaminase antibodies in the small intestine

  1. Mariantonia Maglio*,
  2. Fiorella Florian**,
  3. Monica Vecchiet**,
  4. Renata Auricchio*,
  5. Francesco Paparo*,
  6. Raffaella Spadaro*,
  7. Delia Zanzi*,
  8. Luciano Rapacciuolo*,
  9. Adriana Franzese*,
  10. Daniele Sblattero,
  11. Roberto Marzari** and
  12. Riccardo Troncone (troncone{at}unina.it)*
  1. *Department of Pediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University “Federico II”, Naples, Italy
  2. **Department of Health Sciences, University of Trieste, Trieste, Italy
  3. Department of Medical Sciences, and IRCAD, University of Eastern Piedmont, Novara, Italy

    Abstract

    Objective. Anti-tissue-transglutaminase-antibodies (anti-TG2) are the serological marker of celiac disease (CD). Given the close association between CD and type 1 diabetes, we investigated the production and deposition of anti-TG2-antibodies in the jejunal mucosa of type 1 diabetes children.

    Research Design and Methods. Intestinal biopsies were taken from 33 type 1 diabetes patients with a normal mucosal architecture: 14 had high levels (potential-CD patients) and 19 had normal levels of serum anti-TG2. All biopsies were investigated for intestinal deposits of IgA anti-TG2 by double immunofluorescence. In addition, an antibody analysis using the phage display technique was carried out on the intestinal biopsies from seven type 1 diabetes patients, of which four had elevated and three had normal levels of serum anti-TG2.

    Results. Immunofluorescence studies showed that 11/14 type 1 diabetes children with elevated levels and 11/19 with normal serum levels of anti-TG2 presented with mucosal deposits of such autoantibodies. The phage display analysis technique confirmed the intestinal production of the anti-TG2-antibodies; however, whereas the serum positive type 1 diabetes patients showed a preferential use of the VH5 antibody gene family, in the serum negative patients the anti-TG2-antibodies belonged to VH1 and VH3 families, with a preferential use of the latter.

    Conclusions. Our findings demonstrate that there is intestinal production and deposition of anti-TG2-antibodies in the jejunal mucosa of the majority of type 1 diabetes patients. However, only those with elevated serum levels of anti-TG2-antibodies showed the VH usage that is typical of the anti-TG2-antibodies that are produced in CD patients.

    Footnotes

      • Received July 18, 2008.
      • Accepted April 7, 2009.

    This Article

    1. Diabetes
    1. All Versions of this Article:
      1. db08-0962v1
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