Antibodies to Deamidated Gliadin Peptide in Diagnosis of Celiac Disease in Children

Abstract

The TR-IFMA assay for detecting anti-DGP antibodies shows high sensitivity and specificity for the diagnosis of CD in children. In a majority of our study population, anti-DGP seropositivity preceded TGA positivity, indicating that earlier detection of CD may be possible by monitoring anti-DGP antibodies frequently in genetically susceptible children.

Development of gliadin-specific immune responses in children with HLA-associated genetic risk for celiac disease

“…Although the screening of CD has been for some time based on the measurement of IgA class tTGA, it has been demonstrated that especially IgG-class antibodies to deamidated gliadin peptide (anti-DGP) may appear earlier than tTGA-seropositivity in genetically susceptible children [11,12]. This is in accordance with the suggested significance for T-cell responses to DGPs in the intestinal mucosa in the initiation of the disease process [13].…”

“…Anti-DGP antibodies were measured by using the time-resolved immunofluorometric assay (TR-IFMA), which allows the simultaneous detection of IgA and IgG class antibodies to a synthetic peptide, derived from gamma gliadin of wheat [21]. The cutoff value used for positivity was 153 for IgA and 119 for IgG class anti-DGP antibodies, as determined earlier [12]. A commercial ELISA-based kit was used for measuring tTGA (EliA Celikey, Phadia, Freiburg, Germany).…”

Recent Advances in Celiac Disease

“…Antibodies to deamidated gliadin peptides (anti-DGP) have emerged as another test with high sensitivity and specificity. They may emerge earlier than TTG antibodies and may be particularly useful in diagnosing celiac disease in children under 2-y-old [29,30]. IgG anti-DGP tests may be particularly useful in diagnosing celiac disease in persons with IgA deficiency [31].…”

The CD That Pays Dividends: More Than 15 Years of Deamidated Gliadin Peptide Antibodies

“…Although the authors did not report clinical and histological changes after administration of a gluten-free diet, which could help in identifying these patients as having CD, Hoerter et al also recognize that a prospective design could clarify whether DGP-positive cases are truly ''false positive'' or they represent potential CD cases where a positive serology presages a future CD diagnosis. A recent paper [15] studied CD children in whom serology was obtained as a mean of 1 year before diagnosis was available (and while CD was not suspected). In this context, 35 out of 48 children fulfilling these criteria had positive DGP tests 1 year before definitive CD diagnosis, but had negative IgA tTG [15].…”

“…A recent paper [15] studied CD children in whom serology was obtained as a mean of 1 year before diagnosis was available (and while CD was not suspected). In this context, 35 out of 48 children fulfilling these criteria had positive DGP tests 1 year before definitive CD diagnosis, but had negative IgA tTG [15]. The study suggests that, in a proportion of cases, DGP antibodies could predict CD in children at least 1 year before tTG seroconversion and development of enteropathy.…”