Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction

Thyroid. 2008 Nov;18(11):1171-8. doi: 10.1089/thy.2008.0110.


Background: Individuals with active celiac disease (CD+) have an increased incidence of thyroid dysfunction, which improves on a gluten-free diet (CD-). We investigated whether tissue transglutaminase-2 IgA antibodies (anti-TGase II) present in sera of patients with celiac disease react with thyroid tissue and possibly contribute to thyroid disease.

Methods: Serum from 40 active celiac patients taken before a gluten-free diet (CD+), 46 patients on a gluten-free diet (CD-), 40 normal controls (NC), and 25 with Crohn's disease (CROHN) was used. All sera were screened for antithyroperoxidase antibodies (TPO-AB) and thyroglobulin antibodies (TG-AB), and indirect immunofluorescence (IIF) was performed on primate thyroid tissue sections using TPO-AB- and TG-AB-negative sera.

Results: IIF with thyroid seronegative, anti-TGase II-positive CD+ sera (n = 23) demonstrated staining of thyroid follicular cells and extracellular matrix, in an identical pattern with monoclonal anti-human TGase II antibody. Evidence of TGase II as the antigen in thyroid tissue was supported by elimination of the IIF pattern when sera were depleted of anti-TGase II by pretreatment with human recombinant TGase II. No staining of thyroid tissue was observed when sera from CD+ patients that were negative for TGase II antibodies, or sera from NC subjects were used. Thyroid antibodies were found in 43% of CD+ patients, significantly higher than NC and CROHN patients (p < 0.0001). In addition, a positive correlation was observed between anti-TGase II and TPO-AB titers (p = 0.0001; r = 0.63).

Conclusions: Anti-TGase II antibodies bind to TGase II in thyroid tissue, and titers correlate with TPO antibody titers. These findings suggest that anti-TGase II antibodies could contribute to the development of thyroid disease in celiac disease.

MeSH terms

  • Adult
  • Autoantibodies / blood
  • Autoantibodies / metabolism*
  • Autoantigens / immunology
  • Case-Control Studies
  • Celiac Disease / complications*
  • Celiac Disease / diet therapy
  • Celiac Disease / immunology*
  • Crohn Disease / immunology
  • Diet, Gluten-Free
  • Extracellular Matrix / immunology
  • Fluorescent Antibody Technique, Indirect
  • GTP-Binding Proteins
  • Humans
  • Iodide Peroxidase / immunology
  • Iron-Binding Proteins / immunology
  • Middle Aged
  • Protein Glutamine gamma Glutamyltransferase 2
  • Thyroid Diseases / etiology*
  • Thyroid Diseases / immunology*
  • Thyroid Gland / immunology*
  • Transglutaminases / immunology*


  • Autoantibodies
  • Autoantigens
  • Iron-Binding Proteins
  • TGM2 protein, human
  • anti-thyroglobulin
  • TPO protein, human
  • Iodide Peroxidase
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins