IgA Reticulin Antibody Binding to Human Jejunum in Sera of Children with Coeliac Disease: The Possible Autoantibody of Gluten Sensitive Enteropathy

We recently described IgA antibody in sera of patients with dermatitis herpetiformis (DH) binding to human small bowel tissue in a similar way to tissue bound IgA in the jejunum of DH and coeliac disease (CD) patients (1–3). ‘The purpose of the present study was to investigate IgA anti-jejunal antibody (JAB) in CD children and to compare it with IgG and also with IgA gliadin (AGA) and endomysium (EMA) antibodies. Another aim of the study was to investigate the possible presence of an autoantibody in the disease. A blind study on 175 sera taken from 138 children with malabsorptive syndromes gave the following results: 91% of children with confirmed CD according to ESPGAN criteria had JAB while on a gluten-containing diet, 93% (13/14) of such children before being placed on a gluten-free diet (GFD) and 90% (27/30) on gluten challenge. None of the 21 patients on a GFD for more than one year had JAB. 79% of children with suspected CD with a flat mucosa had JAB: 71% (25/35) of such children who were younger than 2 years, and 94% (16/17) who were older than 2 years.