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[Relevance of anti-tissue transglutaminase antibodies in coeliac disease diagnosis].

Abstract

Coeliac disease is precipitated upon exposure to the dietary wheat gluten. Definitive diagnosis relies on intestinal biopsy and regression of clinical and histological disorders with adherence to a gluten-free diet. Coeliac disease is usually associated with a malabsorption syndrome. However, both atypical and silent clinical forms have been recently described and prevalence of the disease may be under-estimated. Serological tests have been developed in order to select candidates for intestinal biopsy, but these biological parameters are not suitable for screening in the general population. Indeed, antigliadin IgG antibodies have a poor specificity. antigliadin IgA antibodies a poor sensitivity. The detection of antiendomysial IgA antibodies (EmA) by immunofluorescence, although considered as the "gold standard" of serological coeliac disease markers, could not be automated, depends on a subjective fluorescence display, and may be limited by the degree of training of the observer. In year 1997, tissue transglutaminase (tTg) has been identified as the main autoantigen recognized by EmA. On this basis, solid-phase enzyme-linked immunosorbent assays (Elisa) have been developed in order to potentially replace the EmA assay. Several commercial kits are now available but their diagnostic performances have not yet been compared. We selected 75 sera, including sera from 26 patients with coeliac disease in order to evaluate five commercial anti-tTG Elisa kits. For all patients, treated or not, detection of anti-tTG antibodies with four of the five tested kits correlates with EmA test. Kits using human tTG have the highest specificity, equivalent to the value of EMA test, and widely better than antigliadin antibodies. Anti-tTG Elisa kits using human tTG may be used as an alternative way to the EmA assay in the next future, and may supplant IgA anti-gliadin antibodies for coeliac disease screening.

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  • Authors+Show Affiliations

    ,

    Laboratoire d'immunologie, CHRU de Lille, 1 Place de Verdun, 59045 Lille cedex.

    , , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Autoantibodies
    Autoantigens
    Biomarkers
    Case-Control Studies
    Celiac Disease
    Child
    Child, Preschool
    Enzyme-Linked Immunosorbent Assay
    Female
    Fluorescent Antibody Technique
    France
    GTP-Binding Proteins
    Gliadin
    Humans
    Immunoglobulin A
    Immunoglobulin G
    Infant
    Male
    Middle Aged
    Sensitivity and Specificity
    Transglutaminases

    Pub Type(s)

    Comparative Study
    English Abstract
    Journal Article
    Validation Studies

    Language

    fre

    PubMed ID

    12805013

    Citation

    Lepers, S, et al. "[Relevance of Anti-tissue Transglutaminase Antibodies in Coeliac Disease Diagnosis]." Annales De Biologie Clinique, vol. 61, no. 3, 2003, pp. 337-43.
    Lepers S, Soula F, Fily S, et al. [Relevance of anti-tissue transglutaminase antibodies in coeliac disease diagnosis]. Ann Biol Clin (Paris). 2003;61(3):337-43.
    Lepers, S., Soula, F., Fily, S., Fontaine, E., Vuye, S., Colombel, J. F., ... Dubucquoi, S. (2003). [Relevance of anti-tissue transglutaminase antibodies in coeliac disease diagnosis]. Annales De Biologie Clinique, 61(3), pp. 337-43.
    Lepers S, et al. [Relevance of Anti-tissue Transglutaminase Antibodies in Coeliac Disease Diagnosis]. Ann Biol Clin (Paris). 2003;61(3):337-43. PubMed PMID: 12805013.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Relevance of anti-tissue transglutaminase antibodies in coeliac disease diagnosis]. AU - Lepers,S, AU - Soula,F, AU - Fily,S, AU - Fontaine,E, AU - Vuye,S, AU - Colombel,J-F, AU - Guimber,D, AU - Prin,L, AU - Dubucquoi,S, PY - 2003/6/14/pubmed PY - 2003/9/16/medline PY - 2003/6/14/entrez SP - 337 EP - 43 JF - Annales de biologie clinique JO - Ann. Biol. Clin. (Paris) VL - 61 IS - 3 N2 - Coeliac disease is precipitated upon exposure to the dietary wheat gluten. Definitive diagnosis relies on intestinal biopsy and regression of clinical and histological disorders with adherence to a gluten-free diet. Coeliac disease is usually associated with a malabsorption syndrome. However, both atypical and silent clinical forms have been recently described and prevalence of the disease may be under-estimated. Serological tests have been developed in order to select candidates for intestinal biopsy, but these biological parameters are not suitable for screening in the general population. Indeed, antigliadin IgG antibodies have a poor specificity. antigliadin IgA antibodies a poor sensitivity. The detection of antiendomysial IgA antibodies (EmA) by immunofluorescence, although considered as the "gold standard" of serological coeliac disease markers, could not be automated, depends on a subjective fluorescence display, and may be limited by the degree of training of the observer. In year 1997, tissue transglutaminase (tTg) has been identified as the main autoantigen recognized by EmA. On this basis, solid-phase enzyme-linked immunosorbent assays (Elisa) have been developed in order to potentially replace the EmA assay. Several commercial kits are now available but their diagnostic performances have not yet been compared. We selected 75 sera, including sera from 26 patients with coeliac disease in order to evaluate five commercial anti-tTG Elisa kits. For all patients, treated or not, detection of anti-tTG antibodies with four of the five tested kits correlates with EmA test. Kits using human tTG have the highest specificity, equivalent to the value of EMA test, and widely better than antigliadin antibodies. Anti-tTG Elisa kits using human tTG may be used as an alternative way to the EmA assay in the next future, and may supplant IgA anti-gliadin antibodies for coeliac disease screening. SN - 0003-3898 UR - https://www.unboundmedicine.com/medline/citation/12805013/[Relevance_of_anti_tissue_transglutaminase_antibodies_in_coeliac_disease_diagnosis]_ L2 - http://www.jle.com/medline.md?issn=0003-3898&vol=61&iss=3&page=337 DB - PRIME DP - Unbound Medicine ER -