Am J Clin Dermatol 2007; 8 (5): 301-305 ORIGINAL RESEARCH ARTICLE 1175-0561/07/0005-0301/$44.95/0 © 2007 Adis Data Information BV. All rights reserved. Prevalence of Antigliadin Antibodies in Patients with Psoriasis is Not Elevated Compared with Controls Kevin F. Kia, 1 Rajan P. Nair, 1 Robert W. Ike, 2 Ravi Hiremagalore, 1 James T. Elder 1,3 and Charles N. Ellis 1,3 1 Department of Dermatology, University of Michigan Medical School, Ann Arbor, Michigan, USA 2 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA 3 Dermatology Service, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA Background: Antigliadin antibodies (AGAs) are markers of celiac sprue but may have autoimmune implica- Abstract tions in the absence of gastrointestinal disease. There is anecdotal evidence to suggest that gluten sensitivity may play a role in psoriasis, and patients with psoriasis in Europe have been reported to improve on a gluten-free diet. Objective: To assess whether patients with psoriasis in the US have an increased prevalence of elevated AGAs. Method: A US sample of patients with psoriasis (n = 100), patients with psoriasis and psoriatic arthritis (n = 100), and age-matched control individuals without any personal or family history of autoimmune disorders (n = 100) were tested for IgG and IgA AGAs. Results: No difference in the prevalence of abnormal AGAs among patients with psoriasis (14%), combined psoriasis and psoriatic arthritis (18%), and control individuals (19%) was observed. No significant correlations between AGA positivity and psoriasis severity, joint involvement, or age of onset of psoriasis or arthritis were observed. Conclusion: We found no support for the results of prior studies showing that elevated AGAs occur with increased frequency in patients with psoriasis. Furthermore, the relatively high prevalence of abnormal AGAs in our control population suggests these antibodies may not be associated with autoimmune disease. Antibodies to gliadin, the alcohol-soluble portion of gluten, are prevalence of celiac sprue has been reported in patients with markers of celiac sprue and have been reported to be elevated in a psoriasis and in patients with both psoriasis and psoriatic arthri- number of other immune-mediated disorders. [1] Because of a lack tis. [4,6] However, two other studies found no such increased preva- of specificity, the relevance of elevated antigliadin antibodies lence. [3,10] (AGAs) in the absence of celiac-specific markers is unknown, and To date, studies of AGA and psoriasis have been conducted testing AGAs is no longer recommended when assessing patients only in European populations. Our study was undertaken to assess for celiac sprue. [2] whether patients with psoriasis in the US have an increased prevalence of elevated AGAs. There are conflicting reports concerning the prevalence of both abnormal AGAs and celiac sprue in patients with psoriasis. The Materials and Methods largest screening study to suggest an increased prevalence of gluten sensitivity in patients with psoriasis (n = 302) found 16% had abnormal AGAs compared with 10% in a control group. [3] Subjects Similar results were found in patients with psoriatic arthritis. [4] However, four other studies found no increase in AGAs among Patients attending the University of Michigan dermatology or patients with psoriasis. [5-8] In contrast to the estimated 0.75% rheumatology clinics between April 2004 and March 2005 with prevalence of celiac sprue in the general population, [9] a 4% suspected psoriasis or psoriatic arthritis donated blood samples as