Antibody response against gastrointestinal antigens in demyelinating diseases of the central nervous system

Background Antibodies against gastrointestinal antigens may indicate altered microbiota and immune responses in the gut. Recent experimental data suggest a connection between gastrointestinal immune responses and CNS autoimmunity. Methods Antibodies against gliadin, tissue transglutaminase (t TG ), intrinsic factor ( IF ), parietal cells ( PC ) and S accharomyces cerevisiae ( ASCA ) were screened in the sera of 45 patients with AQP 4‐seropositive neuromyelitis optica ( NMO ) and NMO spectrum diseases ( NMO / NMO ‐ SD ), 17 patients with AQP 4‐seronegative NMO , 85 patients with clinically definite multiple sclerosis ( MS ), and 48 healthy controls ( HC ). Results Thirty‐seven percentages of patients with AQP 4‐seropositive NMO / NMO ‐ SD and 28% of patients with MS had at least one particular antibody in contrast to 8% of HC ( P < 0.01, respectively). Antibodies were most common (46%) in AQP 4‐seropositive myelitis ( P = 0.01 versus HS , P = 0.05 versus MS ). Anti‐gliadin and ASCA were more frequent in the AQP 4‐seropositive NMO ‐spectrum compared to controls ( P = 0.01 and P < 0.05, respectively). Conclusion Antibody responses against gastrointestinal antigens are common in MS and AQP 4‐seropositive NMO / NMO ‐ SD , especially in longitudinally extensive myelitis.