Autoimmune diseases of the gastrointestinal tract
Gluten enteropathy( nontropical spruce, adult celiac disease, gluten disease, idiopathic steatorrhea) is a disease that is based on a deficiency of specific enzymes of the peptidase group in the intestinal wall, as a result of which the cleavage of peptin-gluten is broken. Currently, there are two aspects of the pathogenesis of glutaine enteropathy - genetic and immune. Genetically inherited deficiency of peptidases causes incomplete hydrolysis of gluten. The factor of damage to the mucous membrane of the small intestine is considered to be the pathological immune reaction of the intestine to glutein, or, more specifically, to one of its constituent parts, gliadin. Wheat flour contains 7 to 15% protein, 90% of which is gluten. The composition of gluten contains 4 components: albumin, globulin, prolamin and gliadin. Gliadin can be divided into 40 different fractions, which by electrophoretic mobility are combined
into 4 major families of gliadins. The most toxic is a-gliadin. Gluten enteropathy can occur at any age. In adults, it is usually manifested by chronic or recurrent iron deficiency anemia, in children - by retardation of growth and development. For the diagnosis of glutein enteropathy and evaluation of the effectiveness of treatment of the disease, the level of AT is examined for a-gliadin and tissue transglutaminase.
Autoimmune mechanisms play an important role and pathogenesis of inflammatory bowel diseases, which have two main forms: ulcerative colitis and Crohn's disease. The etiology of diseases has not yet been established reliably. To conduct successful therapy and determine the prognosis, it is of great practical importance to conduct differential diagnosis between Crohn's disease and ulcerative colitis.
It is well known that p-ANCA in the blood is detected much more often in patients with ulcerative colitis( in 50-90% of cases) than in patients with Crohn's disease( in 5-20% of cases).For differential diagnosis of Crohn's disease and ulcerative colitis, test systems based on ELISA for the determination of AT to Saccharomyces cerevisiae have been developed, which have high specificity for Crohn's disease.