Intestinal Antibodies to Wheat Fractions in Celiac Disease

SUMMARY

Precipitins to the peptic-tryptic digest of gluten, fraction III, were found in the intestinal secretions (stool or small bowel fluid) of 12 patients with celiac disease but not in control specimens. The intestinal precipitins were demonstrable when the patients were ingesting gluten and were detected in three patients 6 months after the elimination of dietary gluten. Precipitins were more likely to be detected in the small bowel fluid than in the stool, indicating perhaps that the precipitating substance was originating in the upper intestine where the effect of gluten is maximal. Elevated serum IgA levels as well as high titers of hemagglutinating antibodies to gluten were usually present in the blood of patients with active celiac disease. It is proposed that the precipitins represent antibodies that are produced and secreted by the gut. The demonstration of precipitins to gluten fractions in patients with celiac disease may be a specific test for this disorder as well as a clue to the cause of gluten sensitivity.