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Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis

BACKGROUND: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B(12) malabsorption. Intrinsic factor autoantibodies (IFA) are considered markers of pernicious anemia, but their clinical utility in CAG has not been evaluated. This study aimed to assess IFA in CAG...

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Autores principales: Marzinotto, Ilaria, Dottori, Ludovica, Baldaro, Francesca, Dilaghi, Emanuele, Brigatti, Cristina, Bazzigaluppi, Elena, Esposito, Gianluca, Davidson, Howard W., Piemonti, Lorenzo, Lampasona, Vito, Lahner, Edith
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716657/
https://www.ncbi.nlm.nih.gov/pubmed/35005595
http://dx.doi.org/10.1016/j.jtauto.2021.100131
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author Marzinotto, Ilaria
Dottori, Ludovica
Baldaro, Francesca
Dilaghi, Emanuele
Brigatti, Cristina
Bazzigaluppi, Elena
Esposito, Gianluca
Davidson, Howard W.
Piemonti, Lorenzo
Lampasona, Vito
Lahner, Edith
author_facet Marzinotto, Ilaria
Dottori, Ludovica
Baldaro, Francesca
Dilaghi, Emanuele
Brigatti, Cristina
Bazzigaluppi, Elena
Esposito, Gianluca
Davidson, Howard W.
Piemonti, Lorenzo
Lampasona, Vito
Lahner, Edith
author_sort Marzinotto, Ilaria
collection PubMed
description BACKGROUND: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B(12) malabsorption. Intrinsic factor autoantibodies (IFA) are considered markers of pernicious anemia, but their clinical utility in CAG has not been evaluated. This study aimed to assess IFA in CAG patients and controls using a luciferase immunoprecipitation system (LIPS). METHODS: Recombinant nanoluciferase-tagged IF secreted from transfected Expi293F cells was used as antigen in an IFA-LIPS assay. IFA IgG were measured in sera from subjects undergoing gastroscopy and biopsy (updated Sydney system) mainly for anemia (57%) or dyspepsia (34%). This cohort comprised 105 patients with histologically-proven-CAG (cases: median age 64 years, 68% females) and 110 subjects with suspected CAG that were histologically negative (controls: median age 67 years, 54% females). Cut-off values were selected by Q-Q-plot analysis (negative: <2.5 arbitrary units). RESULTS: IFA levels were higher in cases than in controls (Mann-Whitney:p < 10(−5)). The ROC-AUC was 0.67 (95%CI 0.60–0.73, p < 0.0001). The IFA LIPS sensitivity and specificity for CAG were 32% (95% CI 24–42) and 95% (95% CI 90–99). This diagnostic performance remained similar after stratification for the presence/absence of anemia, dyspepsia or vitamin B(12) deficiency. IFA levels were higher in females compared with males (p = 0.0127). In females aged <65 years, IFA-positives were more prevalent than in males (43.5% vs 6.6%, p = 0.011). CONCLUSIONS: The IFA-LIPS assay discriminated between CAG patients and controls showing a good specificity (95%) at the cost of sensitivity (32%). IFA-positivity occurred independently from anemia and vitamin B(12) deficiency, but was more frequent in younger females. IFA testing should be considered in patients at high clinical suspicion of CAG.
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spelling pubmed-87166572022-01-06 Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis Marzinotto, Ilaria Dottori, Ludovica Baldaro, Francesca Dilaghi, Emanuele Brigatti, Cristina Bazzigaluppi, Elena Esposito, Gianluca Davidson, Howard W. Piemonti, Lorenzo Lampasona, Vito Lahner, Edith J Transl Autoimmun Research paper BACKGROUND: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B(12) malabsorption. Intrinsic factor autoantibodies (IFA) are considered markers of pernicious anemia, but their clinical utility in CAG has not been evaluated. This study aimed to assess IFA in CAG patients and controls using a luciferase immunoprecipitation system (LIPS). METHODS: Recombinant nanoluciferase-tagged IF secreted from transfected Expi293F cells was used as antigen in an IFA-LIPS assay. IFA IgG were measured in sera from subjects undergoing gastroscopy and biopsy (updated Sydney system) mainly for anemia (57%) or dyspepsia (34%). This cohort comprised 105 patients with histologically-proven-CAG (cases: median age 64 years, 68% females) and 110 subjects with suspected CAG that were histologically negative (controls: median age 67 years, 54% females). Cut-off values were selected by Q-Q-plot analysis (negative: <2.5 arbitrary units). RESULTS: IFA levels were higher in cases than in controls (Mann-Whitney:p < 10(−5)). The ROC-AUC was 0.67 (95%CI 0.60–0.73, p < 0.0001). The IFA LIPS sensitivity and specificity for CAG were 32% (95% CI 24–42) and 95% (95% CI 90–99). This diagnostic performance remained similar after stratification for the presence/absence of anemia, dyspepsia or vitamin B(12) deficiency. IFA levels were higher in females compared with males (p = 0.0127). In females aged <65 years, IFA-positives were more prevalent than in males (43.5% vs 6.6%, p = 0.011). CONCLUSIONS: The IFA-LIPS assay discriminated between CAG patients and controls showing a good specificity (95%) at the cost of sensitivity (32%). IFA-positivity occurred independently from anemia and vitamin B(12) deficiency, but was more frequent in younger females. IFA testing should be considered in patients at high clinical suspicion of CAG. Elsevier 2021-11-01 /pmc/articles/PMC8716657/ /pubmed/35005595 http://dx.doi.org/10.1016/j.jtauto.2021.100131 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research paper
Marzinotto, Ilaria
Dottori, Ludovica
Baldaro, Francesca
Dilaghi, Emanuele
Brigatti, Cristina
Bazzigaluppi, Elena
Esposito, Gianluca
Davidson, Howard W.
Piemonti, Lorenzo
Lampasona, Vito
Lahner, Edith
Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title_full Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title_fullStr Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title_full_unstemmed Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title_short Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
title_sort intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8716657/
https://www.ncbi.nlm.nih.gov/pubmed/35005595
http://dx.doi.org/10.1016/j.jtauto.2021.100131
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