Am J Clin Exp Immunol 2012;1(1):49-55

Original Article
Lipid-free apolipoprotein A-I exerts an antioxidative role against cell-free
hemoglobin

Dana Ben-Ami Shor, Hedi Orbach, Mona Boaz, Arie Altman, Anaya Juan Manuel, Nicola Bizzaro, Angela Tincani, Ricard
Cervera, Gerard Espinosa, Ljudmila Stojanovich, Blaz Rozman, Stefano Bombardieri, Salvatore De Vita, Jan
Damoiseaux, Danilo Villalta, Elio Tonutti, Renato Tozzoli, Ori Barzilai, Maya Ram, Miri Blank, Nancy Agmon-Levin, Yehuda
Shoenfeld

The Zabludowicz Center for Autoimmune Diseases, Internal Medicine B, Sheba Medical Center affiliated to Sackler
Faculty of Medicine, Tel-Aviv University, Israel; Department of Medicine 'B', E. Wolfson Medical Center, Holon, Israel;
Epidemiology unit, E. Wolfson Medical Center, affiliated to Sackler Faculty of Medicine, Tel-Aviv University, Israel;
Universidad del Rosario, Corporación para Investigaciones Biológicas, Bogota, Columbia; Laboratorio di Patologia
Clinica, Ospedale S. Antonio, Tolmezzo, Italy; Rheumatology and Clinical Immunology, Spedali Civili and University of
Brescia, Brescia, Italy; Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Catalonia, Spain; Bezhanijska
Kosa University Medical Center, Belgrade University, Serbia; Clinical Department of Rheumatology, University Medical
Center Ljubljana, Slovenia; Department of Internal Medicine, Division of Rheumatology, University of Pisa, Pisa, Italy;
Rheumatology Clinic, University of Udine, Udine, Italy; Laboratory of Clinical Immunology, Maastricht University Medical
Center, Maastricht, the Netherlands; Allergology and Clinical Immunology, S. Maria degli Angeli Hospital, Pordenone,
Italy; Immunopathology and Allergology, University Hospital  S. Maria della Misericordia, Udine, Italy; Laboratory of
Clinical Pathology, Civic Hospital, Latisana, Italy

Received April 26, 2012; accepted May 20, 2012; Epub May 22, 2012; Published June 30, 2012

Abstract: Background: Gastrointestinal (GI)-related autoantibodies (Abs) are rarely evaluated in autoimmune diseases
(AID) other than inflammatory bowel disease, autoimmune hepatitis and celiac disease. Our aim was to determine the
prevalence of these antibodies in a wide spectrum of AID. Methods: We examined 923 serum samples representing 18
AID and compared them with 338 samples from healthy subjects. We used the BioPlex 220-immunoassay (Bio-Rad,
USA) to test samples for the presence of IgA and IgG directed at gliadin (AGA), tissue-transglutaminase (tTG), and
Saccharomyces cerevisiae (ASCA). Results: Prevalence of IgA AGA was significantly higher in antiphospholipid
syndrome (APS) (7.1 %, P=0.012) and in pemphigus vulgaris (25%, P =0.008) patients, as compared with healthy
controls. Presence of IgG-AGA was more common among Crohn’s disease (20.5%, P = 0.023) and  rheumatoid arthritis
(6.5%, P=0.027) patients. IgG anti tTG were frequently observed in APS (6.1%, P=0.012), in giant cell arteritis (11.5%, P=0.
013) and in ulcerative colitis (11.1%, P=0.018) patients, and as expected, higher prevalence of ASCA (IgA 19.3% and IgG
27.7%) was found in Crohn’s disease. IgG ASCA were also found in systemic lupus erythematosus (SLE) (4.5%, P=0.
01), in Graves’ disease (5.7%, P=0.018), in cryoglobulinemia (7.1%, P=0.006), and in patients with vasculitides (6.5%,
P=0.002). In contrast, lower prevalence of IgG type AGA was found in  SLE (P=0.034), cryoglobulinemia (P=0.019) and
vasculitides (P=0.013) patients. Conclusions: Our findings suggest an association between GI-related- Abs and a wide
spectrum of AID. The clinical implication of these findings is yet to be determined.  (AJCEI1204002).

Keywords: Gliadin (AGA), tissue-transglutaminase (tTG), Saccharomyces cerevisiae (ASCA), autoantibodies,
inflammatory bowel diseases


Address all correspondence to:
Ben–Ami Shor Dana, MD
Department of gastroenterology & Department of Medicine 'B'
Sheba Medical Center
Tel-Hashomer 52621, Israel
Tel: 972-544-305007
Email: benamidana@gmail.com
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