Immunoblotting analysis of antigliadin antibodies in the sera of patients with dermatitis herpetiformis and gluten-sensitive enteropathy.

Antigliadin antibodies (AGA) were analyzed by immunoblotting from the sera of 30 patients with dermatitis herpetiformis (DH) and of 13 patients with gluten-sensitive enteropathy (GSE). The results were correlated to the jejunal morphology and to the serum AGA values as quantified with an enzyme-linked immunosorbent assay (ELISA). Immunoblotting analysis disclosed a distinct pattern of AGA which was similar in patients with DH and GSE. In both diseases individual variation in IgG class AGA patterns was large, suggesting that several antigenic determinants are involved in the AGA response. The IgA class AGA pattern was clearly more homogeneous. The sera with several bands in immunoblotting had the highest AGA levels in ELISA. Strong staining in the main gliadin area (bands from 31 to 38 kd) indicated severely damaged intestinal mucosa whereas the serum of DH patients with partial villous atrophy or normal mucosa showed usually weaker staining. The immunoblotting pattern of sera from healthy controls was even weaker but was directed against the same polypeptides as in the patients suggesting a quantitative rather than qualitative difference between healthy and diseased subjects. This difference was, however, more obvious in the IgA than in the IgG class AGA pattern possibly indicating a more fundamental defect in the regulation of synthesis of IgA isotype in DH and GSE.