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Enterocyte actin autoantibody detection: a new diagnostic tool in celiac disease diagnosis: results of a multicenter study.
Am J Gastroenterol 2004; 99(8):1551-6AJ

Abstract

OBJECTIVES

This study describes a new method to detect autoantibodies against actin filaments (AAA) as a serological marker of intestinal villous atrophy (IVA) in celiac disease (CD), and reports the results of an Italian double-blind multicenter study.

METHODS

IgA-AAA were analyzed by immunofluorescence using a newly developed method based on intestinal epithelial cells cultured in presence of colchicine. IgA-AAA were blindly evaluated prospectively in 223 antiendomysial antibody (AEA) and/or antitransglutaminase antibody (TGA) positive subjects and in 78 AEA and TGA negative subjects. IgA-AAA positive patients underwent an intestinal biopsy to confirm the diagnosis. Moreover, IgA-AAA were retrospectively investigated in 84 biopsy-proven CD patients and in 2,000 new consecutively collected serum samples from AEA and TGA negative nonbiopsied subjects.

RESULTS

IgA-AAA were positive in 98.2% of the CD patients with flat mucosa, in 89% with subtotal villous atrophy, and in 30% with partial villous atrophy. IgA-AAA were present in none of the AEA and TGA negative nonbiopsied controls. In AEA and/or TGA positive CD patients IgA-AAA positivity significantly correlated with IVA (p < 0.000 in the prospective study, p = 0.005 in the retrospective study). In the prospective study, the values of sensitivity, specificity, the positive predictive value, the negative predictive value, and the efficiency of the IgA-AAA test to identify patients with IVA were, respectively, 83.9%, 95.1%, 97.8%, 69.2%, and 87.0%. Furthermore, a significant correlation (p < 0.0001) was found between the IgA-AAA serum titre and the degree of IVA (rs 0.56).

CONCLUSIONS

The results of this multicenter study show that the new method for IgA-AAA detection could represent a practical diagnostic tool in AEA and/or TGA positive subjects, which would be especially useful when IVA shows a patchy distribution, when the histological picture is difficult to interpret, or when a biopsy could represent a life-threatening risk.

Authors+Show Affiliations

Department of Biomedical Sciences and Biotechnologies, Second Pediatrics Clinic, Cagliari University, Italy.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15307876

Citation

Clemente, M G., et al. "Enterocyte Actin Autoantibody Detection: a New Diagnostic Tool in Celiac Disease Diagnosis: Results of a Multicenter Study." The American Journal of Gastroenterology, vol. 99, no. 8, 2004, pp. 1551-6.
Clemente MG, Musu MP, Troncone R, et al. Enterocyte actin autoantibody detection: a new diagnostic tool in celiac disease diagnosis: results of a multicenter study. Am J Gastroenterol. 2004;99(8):1551-6.
Clemente, M. G., Musu, M. P., Troncone, R., Volta, U., Congia, M., Ciacci, C., ... De Virgiliis, S. (2004). Enterocyte actin autoantibody detection: a new diagnostic tool in celiac disease diagnosis: results of a multicenter study. The American Journal of Gastroenterology, 99(8), pp. 1551-6.
Clemente MG, et al. Enterocyte Actin Autoantibody Detection: a New Diagnostic Tool in Celiac Disease Diagnosis: Results of a Multicenter Study. Am J Gastroenterol. 2004;99(8):1551-6. PubMed PMID: 15307876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enterocyte actin autoantibody detection: a new diagnostic tool in celiac disease diagnosis: results of a multicenter study. AU - Clemente,M G, AU - Musu,M P, AU - Troncone,R, AU - Volta,U, AU - Congia,M, AU - Ciacci,C, AU - Neri,E, AU - Not,T, AU - Maggiore,G, AU - Strisciuglio,P, AU - Corazza,G R, AU - Gasbarrini,G, AU - Cicotto,L, AU - Sole,G, AU - Fasano,A, AU - De Virgiliis,S, PY - 2004/8/17/pubmed PY - 2004/9/21/medline PY - 2004/8/17/entrez SP - 1551 EP - 6 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 99 IS - 8 N2 - OBJECTIVES: This study describes a new method to detect autoantibodies against actin filaments (AAA) as a serological marker of intestinal villous atrophy (IVA) in celiac disease (CD), and reports the results of an Italian double-blind multicenter study. METHODS: IgA-AAA were analyzed by immunofluorescence using a newly developed method based on intestinal epithelial cells cultured in presence of colchicine. IgA-AAA were blindly evaluated prospectively in 223 antiendomysial antibody (AEA) and/or antitransglutaminase antibody (TGA) positive subjects and in 78 AEA and TGA negative subjects. IgA-AAA positive patients underwent an intestinal biopsy to confirm the diagnosis. Moreover, IgA-AAA were retrospectively investigated in 84 biopsy-proven CD patients and in 2,000 new consecutively collected serum samples from AEA and TGA negative nonbiopsied subjects. RESULTS: IgA-AAA were positive in 98.2% of the CD patients with flat mucosa, in 89% with subtotal villous atrophy, and in 30% with partial villous atrophy. IgA-AAA were present in none of the AEA and TGA negative nonbiopsied controls. In AEA and/or TGA positive CD patients IgA-AAA positivity significantly correlated with IVA (p < 0.000 in the prospective study, p = 0.005 in the retrospective study). In the prospective study, the values of sensitivity, specificity, the positive predictive value, the negative predictive value, and the efficiency of the IgA-AAA test to identify patients with IVA were, respectively, 83.9%, 95.1%, 97.8%, 69.2%, and 87.0%. Furthermore, a significant correlation (p < 0.0001) was found between the IgA-AAA serum titre and the degree of IVA (rs 0.56). CONCLUSIONS: The results of this multicenter study show that the new method for IgA-AAA detection could represent a practical diagnostic tool in AEA and/or TGA positive subjects, which would be especially useful when IVA shows a patchy distribution, when the histological picture is difficult to interpret, or when a biopsy could represent a life-threatening risk. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15307876/Enterocyte_actin_autoantibody_detection:_a_new_diagnostic_tool_in_celiac_disease_diagnosis:_results_of_a_multicenter_study_ L2 - http://Insights.ovid.com/pubmed?pmid=15307876 DB - PRIME DP - Unbound Medicine ER -