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Interpretation of serological tests in the diagnosis of celiac disease: Anti-deamidated gliadin peptide antibodies revisited.
Autoimmunity. 2016 09; 49(6):414-420.A

Abstract

Algorithms for celiac disease diagnosis provided by guidelines are based primarily on anti-tissue transglutaminase 2 (TG2) antibodies and/or anti-endomysium antibodies. The place of anti-deamidated gliadin peptide (DGP) antibodies is less well established. This study was designed to assess the clinical relevance of anti-DGP antibodies. Two thousand and twenty-six consecutive unselected patients systematically tested for anti-TG2, endomysium, gliadin, DGP antibodies and IgA dosage were investigated. The serological interpretation was assessed by analyzing the medical records of patients. From the 1984 newly investigated patients suspected of celiac disease, 10% had at least one celiac marker. Anti-TG2, anti-endomysium, anti-gliadin and anti-DGP antibodies were found in 1.1%, 0.6%, 6.8% and 4.1% of cases respectively, with different combinations. The diagnosis of celiac disease was retained in 0.45% of patients. When using the duodenal biopsies as a gold standard, analysis of the anti-DGP diagnosis performance showed that the specificity and the predictive positive value (PPV) were lower than that of the anti-TG2 assay. The combined detection of anti-TG2 and anti-DGP antibodies had a lower PPV than that of anti-TG2 and anti-endomysium antibodies (p = 0.04). When analyzing the contribution of anti-DGP antibodies as an additional marker to both anti-TG2 and anti-endomysium antibodies, the PPV of the three associated antibodies was shown to be significantly lower than the PPV of the both anti-TG2 and anti-endomysium antibodies (p = 0.04). As a conclusion, anti-DGP antibodies may not have the diagnosis value required as an additional screening test to anti-TG2 antibodies for identifying celiac disease patients in medical centers where anti-endomysium detection is available.

Authors+Show Affiliations

a Department of Immunology , Robert Debré Hospital, Reims University Hospitals , Reims , France.a Department of Immunology , Robert Debré Hospital, Reims University Hospitals , Reims , France. b Faculty of Medicine , University of Reims Champagne-Ardenne , Reims , France.a Department of Immunology , Robert Debré Hospital, Reims University Hospitals , Reims , France.c Department of Internal Medicine , Infectious Diseases, Clinical Immunology, Robert Debré Hospital, Reims University Hospitals , Reims , France , and.a Department of Immunology , Robert Debré Hospital, Reims University Hospitals , Reims , France.d Clinical Research Unit, Reims University Hospitals , Reims , France.a Department of Immunology , Robert Debré Hospital, Reims University Hospitals , Reims , France. b Faculty of Medicine , University of Reims Champagne-Ardenne , Reims , France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27452003

Citation

Zucchini, Laure, et al. "Interpretation of Serological Tests in the Diagnosis of Celiac Disease: Anti-deamidated Gliadin Peptide Antibodies Revisited." Autoimmunity, vol. 49, no. 6, 2016, pp. 414-420.
Zucchini L, Giusti D, Gatouillat G, et al. Interpretation of serological tests in the diagnosis of celiac disease: Anti-deamidated gliadin peptide antibodies revisited. Autoimmunity. 2016;49(6):414-420.
Zucchini, L., Giusti, D., Gatouillat, G., Servettaz, A., Tabary, T., Barbe, C., & Pham, B. N. (2016). Interpretation of serological tests in the diagnosis of celiac disease: Anti-deamidated gliadin peptide antibodies revisited. Autoimmunity, 49(6), 414-420.
Zucchini L, et al. Interpretation of Serological Tests in the Diagnosis of Celiac Disease: Anti-deamidated Gliadin Peptide Antibodies Revisited. Autoimmunity. 2016;49(6):414-420. PubMed PMID: 27452003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interpretation of serological tests in the diagnosis of celiac disease: Anti-deamidated gliadin peptide antibodies revisited. AU - Zucchini,Laure, AU - Giusti,Delphine, AU - Gatouillat,Grégory, AU - Servettaz,Amélie, AU - Tabary,Thierry, AU - Barbe,Coralie, AU - Pham,Bach-Nga, Y1 - 2016/07/23/ PY - 2016/7/28/pubmed PY - 2017/12/23/medline PY - 2016/7/26/entrez KW - Deamidated gliadin peptides KW - anti-endomysium antibodies KW - anti-tissue transglutaminase antibodies KW - autoantibodies KW - duodenal biopsies SP - 414 EP - 420 JF - Autoimmunity JO - Autoimmunity VL - 49 IS - 6 N2 - Algorithms for celiac disease diagnosis provided by guidelines are based primarily on anti-tissue transglutaminase 2 (TG2) antibodies and/or anti-endomysium antibodies. The place of anti-deamidated gliadin peptide (DGP) antibodies is less well established. This study was designed to assess the clinical relevance of anti-DGP antibodies. Two thousand and twenty-six consecutive unselected patients systematically tested for anti-TG2, endomysium, gliadin, DGP antibodies and IgA dosage were investigated. The serological interpretation was assessed by analyzing the medical records of patients. From the 1984 newly investigated patients suspected of celiac disease, 10% had at least one celiac marker. Anti-TG2, anti-endomysium, anti-gliadin and anti-DGP antibodies were found in 1.1%, 0.6%, 6.8% and 4.1% of cases respectively, with different combinations. The diagnosis of celiac disease was retained in 0.45% of patients. When using the duodenal biopsies as a gold standard, analysis of the anti-DGP diagnosis performance showed that the specificity and the predictive positive value (PPV) were lower than that of the anti-TG2 assay. The combined detection of anti-TG2 and anti-DGP antibodies had a lower PPV than that of anti-TG2 and anti-endomysium antibodies (p = 0.04). When analyzing the contribution of anti-DGP antibodies as an additional marker to both anti-TG2 and anti-endomysium antibodies, the PPV of the three associated antibodies was shown to be significantly lower than the PPV of the both anti-TG2 and anti-endomysium antibodies (p = 0.04). As a conclusion, anti-DGP antibodies may not have the diagnosis value required as an additional screening test to anti-TG2 antibodies for identifying celiac disease patients in medical centers where anti-endomysium detection is available. SN - 1607-842X UR - https://www.unboundmedicine.com/medline/citation/27452003/Interpretation_of_serological_tests_in_the_diagnosis_of_celiac_disease:_Anti_deamidated_gliadin_peptide_antibodies_revisited_ L2 - https://www.tandfonline.com/doi/full/10.1080/08916934.2016.1203908 DB - PRIME DP - Unbound Medicine ER -