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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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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. |
format | Online Article Text |
id | pubmed-8716657 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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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