Autoantibodies to Human Tissue Transglutaminase: Superior Predictors of Coeliac Disease

Blackwell, P; Hill, P G; Holmes, G. K. T.

doi:10.1080/003655202761020551

Cited by 25 publications

(21 citation statements)

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“…The prevalence of CD exhibits an iceberg effect; the number of asymptomatic cases with positive serology and biopsy is 5-to 7-fold higher than typical symptomatic individuals exhibiting signs and symptoms including abdominal pain, growth retardation, short stature, chronic diarrhea, iron deficiency anemia that is refractive to treatment and intestinal lymphoma (6,12,21,29) . Serologic tests such as the anti-endomysium IgA antibody test (EMA), the anti-tissue transglutaminase immunoglobulin (Ig) A antibody test (anti-tTG Ab) and HLA DQ2 or DQ8 genotype testing are useful for evaluation of asymptomatic subjects as well as patients with diabetes mellitus, thyroiditis, Down syndrome, Turner syndrome, William syndrome, IgA deficiency and first-degree relatives of patients with CD (1,4,5,17) . It is therefore logical to screen these populations for other autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of celiac disease in siblings of Iranian patients with celiac disease

Chomeili¹,

Aminzadeh²,

Hardani³

et al. 2011

Arq. Gastroenterol.

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-Context -Celiac disease, one of the best-known autoimmune human leukocyte antigen-dependent disorders, has a relatively increased prevalence in first-degree relatives. Objective -To determine the prevalence of celiac disease in siblings of patients with confirmed celiac disease. Methods -Siblings of confirmed celiac disease patients in our center were identified and enrolled in this study. Their serum immunoglobulin A and tissue transglutaminase antibody-enzyme-linked immunosorbent assay (anti-tissue transglutaminase, immunoglobulin A, and immunoglobulin G) were measured and multiple endoscopic duodenal biopsy specimens were obtained with parental consensus. Celiac disease was confirmed by observation of characteristic histological changes. Results -A total of 49 children (male, 29; female, 20; age, 2-16 years) with confirmed celiac disease in a pediatric gastroenterology ward were studied from 1999 to 2006. We found 30 siblings (female, 16) all shared in both parents. The only measurement available was for immunoglobulin A tissue transglutaminase antibody. A duodenal biopsy was performed in all 30 siblings. Clinical findings such as abdominal pain, fatigue, growth retardation and diarrhea were found in 53.3% of the completely studied siblings, and positive serology without histological changes was identified in four cases. Both serology and biopsy (confirmed new cases) were positive in 2 of the 30 siblings. Conclusion -High prevalence of celiac disease among siblings of patients with confirmed celiac disease necessitates serologic screening (and confirmatory biopsy if indicated) in families having celiac disease. It is advantageous to diagnose the disease as soon as possible because early diagnosis and diet intervention may prevent serious complications such as growth retardation, short stature, chronic diarrhea, and malignancy.

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Section: Introductionmentioning

confidence: 99%

Prevalence of celiac disease in siblings of Iranian patients with celiac disease

Chomeili¹,

Aminzadeh²,

Hardani³

et al. 2011

Arq. Gastroenterol.

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“…for the detection of anti-tTG antibodies (10,13,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). Few studies, however, have compared the available htTG-based tests (10,17,(25)(26)(27), and these studied only a limited number of the available tests [three methods in Ref.…”

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confidence: 99%

“…Few studies, however, have compared the available htTG-based tests (10,17,(25)(26)(27), and these studied only a limited number of the available tests [three methods in Ref. (27 ), four in Refs.…”

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confidence: 99%

“…The reports also had limitations with respect to selection of patients and controls. For example, in some studies, positive and negative samples were selected based on the EMA results (10,17,26 ). This precluded calculation of diagnostic characteristics such as sensitivity and specificity of the anti-tTG assay or comparing its diagnostic accuracy with that of the EMA.…”

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confidence: 99%

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Diagnostic Accuracy of Ten Second-Generation (Human) Tissue Transglutaminase Antibody Assays in Celiac Disease

Meensel

Hiele²,

Hoffman³

et al. 2004

Clinical Chemistry

101

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Background: Anti-tissue transglutaminase (tTG) assays that use human tTG as antigen have recently become available. We evaluated commercially available assays with human tTG antigen to estimate their diagnostic accuracies and to determine whether they agree sufficiently to be used interchangeably. Methods: Ten commercially available second-generation anti-tTG assays were evaluated. The following populations were studied: celiac disease (CD) patients at the time of diagnosis without (n ‫؍‬ 70) or with (n ‫؍‬ 5) IgA deficiency; diseased controls (n ‫؍‬ 70); and CD patients without (n ‫؍‬ 28) or with (n ‫؍‬ 2) IgA deficiency during follow-up. All individuals included in the study underwent intestinal biopsy. Technical performance (linearity, interference, precision, correlation, and agreement) and diagnostic accuracy (sensitivity and specificity) were compared. Anti-gliadin and anti-endomysium antibodies were also measured. Results: IgA anti-tTG results correlated well overall, but numerical values differed. Diagnostic sensitivity ranged between 91% and 97% and specificity between 96% and 100%. These were higher than the sensitivity and specificity of the IgA endomysium assay and the IgA gliadin assay. Generally, IgG anti-tTG was less sensitive but more specific than IgG anti-gliadin for the diagnosis of CD in the small group of IgA-deficient patients. Conclusions: Overall diagnostic performance of IgA tTG assays is acceptable and comparable among the

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“…Second-generation kits using purified human tTG or human recombinant tTG were developed and introduced in routine practice. Several studies compared the firstand second-generation kits and concluded that the human antigens improve assay sensitiv-ity and selectivity [63,[74][75][76]. A third generation of kits using tTG-gliadin peptide complexes as the antigen has also been proposed; however, it seems to have no advantage over human recombinant antigen kits, especially regarding specificity [77,78].…”

Section: Biological Markersmentioning

confidence: 99%

Celiac disease diagnosis and gluten-free food analytical control

et al. 2010

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Celiac disease (CD) is an autoimmune entero-pathy, characterized by an inappropriate T-cell-mediated immune response to the ingestion of certain dietary cereal proteins in genetically susceptible individuals. This disorder presents environmental, genetic, and immunological com-ponents. CD presents a prevalence of up to 1% in populations of European ancestry, yet a high percentage of cases remain underdiagnosed. The diagnosis and treatment should be made early since untreated disease causes growth retardation and atypical symptoms, like infertility or neurological disorders. The diagnostic criteria for CD, which requires endoscopy with small bowel biopsy, have been changing over the last few decades, especially due to the advent of serological tests with higher sensitivity and specificity. The use of serological markers can be very useful to rule out clinical suspicious cases and also to help monitor the patients, after adherence to a gluten-free diet. Since the current treatment consists of a life-long gluten-free diet, which leads to significant clinical and histological improvement, the standardization of an assay to assess in an unequivocal way gluten in gluten-free foodstuff is of major importance.

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Autoantibodies to Human Tissue Transglutaminase: Superior Predictors of Coeliac Disease

Abstract: All human antigen kits showed significantly higher sensitivity for coeliac disease compared to guinea pig antigen (P < 0.001). Receiver operating characteristic curves confirmed the superior diagnostic accuracy of the human antigen kits.

Cited by 25 publications

References 0 publications

Prevalence of celiac disease in siblings of Iranian patients with celiac disease

Prevalence of celiac disease in siblings of Iranian patients with celiac disease

Diagnostic Accuracy of Ten Second-Generation (Human) Tissue Transglutaminase Antibody Assays in Celiac Disease

Celiac disease diagnosis and gluten-free food analytical control

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