ORGÁNOVĚ SPECIFICKÉ PROTILÁTKYU DĚTÍ S IDIOPATICKÝMI STŘEVNÍMI ZÁNĚTYA JEJICH UŽITÍ V KLINICKÉ PRAXI

Organ Specific Antibodies in Children with Idiopathic InflammatoryBowel Disease and Their Employment in Clinical Practice

Background.
Ethiopathogenesis of the idiopathic inflammatory bowel disease has not been yet fully explained.Several abnormalities of the humoral immunity supporting the concept of autoimmune character of the disease havebeen identified. The aim of our study was to characterise occurrence of the organ specific antibodies against theintestinal goblet cells and against acinar cells of the exocrine pancreatic tissue and to evaluate their significance forthe diagnostics of the idiopathic inflammatory bowel disease.Methods and Results. 69 children were included in the study. The group consisted of 20 patients with idiopathicproctocolitis (11 boys and 9 girls, 6 to 18 years old, average age 15.5) and 14 patients with Crohns disease (9 boysand 5 girls, 5 to 18 years old, average age 14.7). Control group included 35 children (20 boys and 15 girls, averageage 14.7). In patients of the idiopathic proctocolitis group, antibodies against the intestinal goblet cells were assayedby indirect immunofluorescence method in 55%. In patients with Crohns disease, antibodies against acinar cells ofthe exocrine pancreatic tissue were found in 64.2 %. Differences in manifestation of antibodies against acinar cellsof the exocrine pancreatic tissue in Crohns disease were statistically significant (p=0.001). Statistically significant(p=0.01) was also the difference of levels of antibodies against the intestinal goblet cells in patients with idiopathicproctocolitis when compared to patients with Crohns disease. Statistically significant difference (p=0.01) was foundin levels of antibodies against acinar cells of the exocrine pancreatic tissue in Crohns disease and antibodies againstthe intestinal goblet cells in patients with idiopathic proctocolitis.Conclusion. Testing on presence of specific antibodies against acinar cells of the exocrine pancreatic tissue andagainst intestinal goblet cells is a valuable tool for the diagnostics of the idiopathic inflammatory bowel disease inchildhood and adolescence.

Key words:
idiopathic inflammatory bowel disease, idiopathic proctocolitis, Crohns disease, immunofluorescence,specific antibodies, acinar cells of the exocrine pancreatic tissue, intestinal goblet cells.