Anti-Parietal Cell Antibody

Parietal cells are responsible for hydrochloric acid production in the stomach and secretion of intrinsic factor, a glycoprotein required for the uptake of cyanocobalamin/vitamin B12 in the terminal part of the ileum. High prevalence of PCA (parietal-cell antibodies) is found in patients with pernicious anaemia (up to 90%), and chronic atrophic gastritis. The specificity of PCA is limited due to prevalence in apparently healthy blood donors (9%) and other associated diseases.

In advanced stages of chronic atrophic gastritis, atrophy of the stomach mucosa develops, characterised by a continuous decrease in hydrochloric acid production. For all PCA-positive patients, who also underwent an endoscopic examination, the serological diagnosis of “chronic atrophic gastritis” could be confirmed by the endoscopic result. The prevalence is almost 100% unless the stomach mucosa is not yet fully atrophic. As chronic atrophic gastritis is the highest risk factor for the development of gastric carcinoma, early diagnosis by PCA detection is of particular importance. In numerous investigations, a Helicobacter pylori infection was detected in 50-70% of chronic atrophic gastritis cases during the early stage of the disease. Hence, the aetiological cascade Helicobacter pylori infection to chronic atrophic gastritis to gastric carcinoma is of great significance for the diagnostic and therapeutic approach as regards the serological detection of PCA and antibodies against Helicobacter pylori and suitable treatment.

Pernicious anaemia (PA) is characterised by vitamin B12 deficiency with symptoms of hyperchromic anaemia. Characteristic is the occurrence of megaloblasts in the bone marrow and megalocytes in the blood. PA develops from chronic atrophic gastritis. There is a causative link to primary intrinsic factor deficiency and secondary vitamin B12 deficiency. The decrease in the prevalence of autoantibodies against parietal cells during the course of pernicious anaemia is of particular importance. This is likely to be caused by the permanent loss of parietal cells and the resulting reduction in autoantigens. [Modified from the EUROIMMUN Package Insert Version: 29/10/2018.]