Parietal Cell Antibody ELISA and Intrinsic Factor Antibody

39 Pages·2017·1.13 MB·English

Parietal Cell Antibody ELISA and
Intrinsic Factor Antibody
Ban-Hock Toh
MBBS, DSc, FRACP, FRCPA
Emeritus Professor, Monash University
Immunopathologist, Australian Clinical labs
Phadia user group meeting
Rydges Sydney Airport Hotel, Dreamliner 1 Room
23rd November 2017
Parietal Cell Antibody = Autoimmune Gastritis
(Asymptomatic)
Parietal cell antibody is a serum diagnostic marker for
autoimmune gastritis identified by gastric biopsy
Autoimmune Gastritis affects Fundus, spares Antrum
Parietal cells produce
• Acid (Iron absorption)
Parietal,
Parietal cells
• Intrinsic factor
cells
(B12 absorption)
Destroyed
• Iron def anemia
• B12 def (Pernicious)
anemia
Antral G cells
produce gastrin
Autoimmune Gastritis
c
i
t
a
m
o 10-20 yrs
t
p
m
Parietal
y
s
A Chronic Atrophic Gastritis Cell
Antibody
Parietal cell destruction
to gastric
Loss of acid and intrinsic factor
H/K
Intrinsic factor antibody
ATPase
Fe-deficient/Pernicious/anaemia
Autoimmune Gastritis progresses to Atrophic Gastritis
Autoimmune Gastritis Gastric Atrophy
Whittingham S, Mackay I and Toh BH. Current medical literature-Gastroenterology 2007,
26: 29-36.
End-Stage Chronic Atrophic Gastritis of
Fundus sparing Antrum
ANTRUM
FUNDUS
(Corpus)
(Body)
Ian Mackay
Intestinal Metaplasia: mucous cells replace
parietal, zymogenic and ECL cells
Premalignant
Gastric cancer
Ian Mackay
Parietal cell antibodies
Parietal cell antibodies target gastric H/K
ATPase a and b subunits
a
b
Immunoblotting
of stomach
membranes with
parietal cell
antibody
Callaghan J, Khan A, Alderuccio F, van Driel I Gleeson P, Toh BH. Autoimmunity. 1993;16:289
b subunit of the gastric H/K ATPase is a heavily glycosylated
35 kDa core protein
Proc Nat Acad Sci, 1990; 87, 6418-6422
60-90 kd
The 60-90 kDa parietal cell autoantigen associated with autoimmune
b subunit gastritis is a b subunit of the gastric H/K ATPase (proton pump)
Toh BH et al
35 kd core protein