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 B12 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 p...

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Autores principales:	Ilaria Marzinotto, Ludovica Dottori, Francesca Baldaro, Emanuele Dilaghi, Cristina Brigatti, Elena Bazzigaluppi, Gianluca Esposito, Howard W. Davidson, Lorenzo Piemonti, Vito Lampasona, Edith Lahner
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Atrophic gastritis Autoimmune gastritis Gastric autoantibodies Intrinsic factor antibodies Parietal cell antibodies Luciferase immunoprecipitation system Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/33b6430e45e84ecc86dd1ba059944e08
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spelling	oai:doaj.org-article:33b6430e45e84ecc86dd1ba059944e082021-11-06T04:35:41ZIntrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis2589-909010.1016/j.jtauto.2021.100131https://doaj.org/article/33b6430e45e84ecc86dd1ba059944e082021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589909021000514https://doaj.org/toc/2589-9090Background: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B12 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 B12 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 B12 deficiency, but was more frequent in younger females. IFA testing should be considered in patients at high clinical suspicion of CAG.Ilaria MarzinottoLudovica DottoriFrancesca BaldaroEmanuele DilaghiCristina BrigattiElena BazzigaluppiGianluca EspositoHoward W. DavidsonLorenzo PiemontiVito LampasonaEdith LahnerElsevierarticleAtrophic gastritisAutoimmune gastritisGastric autoantibodiesIntrinsic factor antibodiesParietal cell antibodiesLuciferase immunoprecipitation systemImmunologic diseases. AllergyRC581-607ENJournal of Translational Autoimmunity, Vol 4, Iss , Pp 100131- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Atrophic gastritis Autoimmune gastritis Gastric autoantibodies Intrinsic factor antibodies Parietal cell antibodies Luciferase immunoprecipitation system Immunologic diseases. Allergy RC581-607
spellingShingle	Atrophic gastritis Autoimmune gastritis Gastric autoantibodies Intrinsic factor antibodies Parietal cell antibodies Luciferase immunoprecipitation system Immunologic diseases. Allergy RC581-607 Ilaria Marzinotto Ludovica Dottori Francesca Baldaro Emanuele Dilaghi Cristina Brigatti Elena Bazzigaluppi Gianluca Esposito Howard W. Davidson Lorenzo Piemonti Vito Lampasona Edith Lahner Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
description	Background: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B12 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 B12 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 B12 deficiency, but was more frequent in younger females. IFA testing should be considered in patients at high clinical suspicion of CAG.
format	article
author	Ilaria Marzinotto Ludovica Dottori Francesca Baldaro Emanuele Dilaghi Cristina Brigatti Elena Bazzigaluppi Gianluca Esposito Howard W. Davidson Lorenzo Piemonti Vito Lampasona Edith Lahner
author_facet	Ilaria Marzinotto Ludovica Dottori Francesca Baldaro Emanuele Dilaghi Cristina Brigatti Elena Bazzigaluppi Gianluca Esposito Howard W. Davidson Lorenzo Piemonti Vito Lampasona Edith Lahner
author_sort	Ilaria Marzinotto
title	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_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_sort	intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/33b6430e45e84ecc86dd1ba059944e08
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Intrinsic factor autoantibodies by luminescent immuno-precipitation system in patients with corpus atrophic gastritis

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