GASTRIC ANTIBODIES STUDIED BY FLUORESCENCE MICROSCOPY

¹ Department of Therapeutics, Royal Infirmary, Edinburgh

Antibody specific for the mucosa of the body of human stomach was detected by the method of complement-fixation in 62 per cent of patients with Addisonian pernicious anæmia, in 20 per cent of patients with Hashimoto thyroiditis, in 25 per cent of patients with spontaneous hypothyroidism, and in 3 per cent of blood donors. Using the technique of fluorescence microscopy the specificity of this gastric antibody has been further defined to a particulate component of parietal cell cytoplasm. It is an auto-antibody that will react equally well with homologous gastric mucosa provided the mucosa contains a normal concentration of healthy parietal cells. The indirect fluorescent antibody technique is a more sensitive test for parietal cell antibody than the method of complementfixation and the incidence of positive results in Addisonian pernicious anæmia, Hashimoto thyroiditis, spontaneous hypothyroidism and blood donors is correspondingly higher at 78, 25, 32 and 4 per cent respectively. Complementfixing gastric antibody is distinct from antibody to intrinsic factor but the latter does not appear to stain any other cell type in the gastric body mucosa with the fluorescent antibody technique.

The relationship between pernicious anæmia, chronic thyroiditis and idiopathic adrenal insufficiency is discussed and it is argued that one of the basic factors in the pathogenesis of these three conditions is a genetically determined defect in immunological tolerance.

Note:

I am grateful to Dr. Roland Alexander of the Northern General Hospital, Edinburgh, for his tuition on the technique of fluorescence microscopy and for a supply of fluorescien isothiocyanate, to Dr. Howard Davies of the Department of Hæmatology, Royal Infirmary, for the gastric biopsies and for sera from patients with Addisonian pernicious anæmia, to Dr. R. A. Cumming for sera from the blood donors, to Miss Isobel Riding of the Blood Transfusion Service for her work on antibody to intrinsic factor, and to Miss Laura Scarth, Miss Geraldine Walker and Mrs. Maida Anderson for their invaluable technical assistance. The work was supported by a grant from the Medical Research Council.