Atrophic Gastritis and Autoimmunity: Results from a Prospective, Multicenter Study

Małgorzata Osmola , Caroline A.F. Hemont (1) , Nicolas Chapelle (1, 2) , Marie Anne Vibet (1) , David Tougeron (3) , Driffa Moussata (4) , Dominique Lamarque (5) , Édith Bigot-Corbel (1) , Damien Masson (1) , Justine Blin (1, 6) , Maxime Leroy (1) , Régis Josien (2, 1) , Jean François Mosnier (1) , Jerôme C. Martin (2, 1) , Tamara Matysiak-Budnik (2, 1)

1 CHU Nantes - Centre Hospitalier Universitaire de Nantes
2 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
3 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
4 CHU Trousseau [Tours]
5 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
6 TENS - The Enteric Nervous System in gut and brain disorders [U1235]

Despite a global decrease, gastric cancer (GC) incidence appears to be increasing recently in young, particularly female, patients. The causal mechanism for this “new” type of GC is unknown, but a role for autoimmunity is suggested. A cascade of gastric precancerous lesions, beginning with chronic atrophic gastritis (CAG), precedes GC. To test the possible existence of autoimmunity in patients with CAG, we aimed to analyze the prevalence of several autoantibodies in patients with CAG as compared to control patients. Sera of 355 patients included in our previous prospective, multicenter study were tested for 19 autoantibodies (anti-nuclear antibodies, ANA, anti-parietal cell antibody, APCA, anti-intrinsic factor antibody, AIFA, and 16 myositis-associated antibodies). The results were compared between CAG patients (n = 154), including autoimmune gastritis patients (AIG, n = 45), non-autoimmune gastritis patients (NAIG, n = 109), and control patients (n = 201). ANA positivity was significantly higher in AIG than in NAIG or control patients (46.7%, 29%, and 27%, respectively, p = 0.04). Female gender was positively associated with ANA positivity (OR 0.51 (0.31–0.81), p = 0.005), while age and H. pylori infection status were not. Myositis-associated antibodies were found in 8.9% of AIG, 5.5% of NAIG, and 4.4% of control patients, without significant differences among the groups (p = 0.8). Higher APCA and AIFA positivity was confirmed in AIG, and was not associated with H. pylori infection, age, or gender in the multivariate analysis. ANA antibodies are significantly more prevalent in AIG than in control patients, but the clinical significance of this finding remains to be established. H. pylori infection does not affect autoantibody seropositivity (ANA, APCA, AIFA). The positivity of myositis-associated antibodies is not increased in patients with CAG as compared to control patients. Overall, our results do not support an overrepresentation of common autoantibodies in patients with CAG.

Mots clés: autoimmune gastritis; autoimmunity; chronic atrophic gastritis; gastric cancer; H. pylori

Domaines: Sciences du Vivant [q-bio]

Małgorzata Osmola, Caroline A.F. Hemont, Nicolas Chapelle, Marie Anne Vibet, David Tougeron, et al.. Atrophic Gastritis and Autoimmunity: Results from a Prospective, Multicenter Study. Diagnostics, 2023, 13 (9), ⟨10.3390/diagnostics13091599⟩. ⟨hal-04106347⟩