Coeliac disease in the year 2000: exploring the iceberg

Catassi, Carlo; Rätsch, I M; Fabiani, Elisabetta; Rossini, Michele; Bordicchia, F; Candela, Fernando; Coppa, G V; Giorgi, Pier Luigi

doi:10.1016/s0140-6736(94)90989-x

Cited by 638 publications

(312 citation statements)

References 15 publications

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“…CD is one of the most common gastrointestinal disorders, with a prevalence of 1:100-1:200 in the general population (1)(2)(3). The large increase in CD diagnosis over recent decades is in large part due to the availability of immunoassays with excellent diagnostic accuracy, such as the IgA anti-transglutaminase (anti-tTG) antibody assay (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Brusca

Carroccio²,

Tonutti³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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Background: In the diagnosis of celiac disease (CD), serum assays for anti-endomysium (EMA) and anti-transglutaminase (anti-tTG) antibodies have excellent diagnostic accuracy. However, these assays are less sensitive in young pediatric patients. Recently, a new ELISA test using deamidated gliadin peptides (DGP) as antigen has proved to be very sensitive and specific even in pediatric patients. In addition, anti-actin IgA antibodies (AAA) is another test that can be used in CD patients because antibody concentrations correlate with the degree of villous atrophy. This study evaluated the clinical accuracy of anti-tTG, EMA, AGA, anti-DGP and AAA and the effectiveness of these in different combinations for diagnosing CD in a large cohort of pediatric patients. Methods: Sera of 150 children under 6 years of age were tested: 95 patients had a diagnosis of CD, while 55 patients who did not suffer from CD were used as controls. Anti-DGP IgA/IgG and AAA were assayed with ELISA kits, while anti-tTG IgA/IgG and AGA IgG/IgA were assayed using a quantitative fluoroimmunoassay. The EMA test was conducted by indirect immunofluorescence.

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Section: Introductionmentioning

confidence: 99%

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Brusca

Carroccio²,

Tonutti³

et al. 2012

Clinical Chemistry and Laboratory Medicine

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“…The end result of this immune response to gluten is reversible damage to the enterocytes, with flattening of the intestinal villi and consequent malabsorption (9)(10)(11). A diagnosis of CD is based on the typical signs and symptoms associated with the presence of specific antitTG or anti-endomysial autoantibodies (EMA) (12)(13)(14). AGA testing currently has little diagnostic significance, because the methods used to identify them present lower levels of sensitivity and specificity than tests for antitTG or EMA (15,16).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic efficacy of the ELISA test for the detection of deamidated anti‐gliadin peptide antibodies in the diagnosis and monitoring of celiac disease

Tonutti

Visentini

Picierno

et al. 2009

Clinical Laboratory Analysis

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Background and Aim: We evaluated the diagnostic performance of an ELISA test for anti-gliadin IgA and IgG antibodies, which uses synthetic deamidated gliadin peptides (anti-gliadin antibodies, AGAs) as coating; the results were compared with a test that uses extracted gliadin (AGAe). Methods: The study was conducted on the sera of 144 patients suffering from celiac disease (CD), including 20 patients with IgA deficiency and 9 who were following a gluten-free diet (GFD), and 129 controls. Results: In the 115 CD patients (without IgA deficiency), the sensitivity of AGAe IgA and IgG was 32.2 and 60.9%, whereas that of AGAs IgA and IgG was 59.1 and 72.2%. The specificity for AGAe IgA and IgG, and AGAs IgA and IgG was 93.8 and 89.9%, and 96.9% and 99.2%, respectively. Of the 20 patients with CD and IgA deficiency, 7 tested positive for AGAe IgG and 14 for AGAs IgG. The test using deamidated gliadin peptides performed better in terms of sensitivity and specificity than the AGA tests with extracted antigen. Conclusions: The very high specificity of the AGAs IgG test (99.2%) also suggests that patients who test positive with this assay require a thorough followup, even if the anti-tissue transglutaminase antibodies (anti-tTG) and anti-endomysial autoantibodies (EMA) assays are negative.

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“…It is nowadays evident that CD is one of the most common life-long diseases, with a frequency around 1:100-1:200 in the general population [1][2][3]. The enormous increase in CD diagnoses in recent decades is in large part due to the availability of serum tests with excellent diagnostic accuracy, such the anti-endomysium and antitransglutaminase assays [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

IgA anti-actin antibodies ELISA in coeliac disease: A multicentre study

Carroccio

Brusca

Iacono

et al. 2007

Digestive and Liver Disease

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Background. Previous studies have demonstrated that serum anti-actin antibodies are a reliable marker of intestinal damage severity in coeliac disease.Aims. To validate in a multicentre study the clinical usefulness of serum IgA anti-actin antibody ELISA and its possible use in monitoring intestinal mucosa lesions during gluten-free diet.Patients and methods. Four centres recruited 205 newly diagnosed coeliac disease patients with villous atrophy, 80 healthy controls and 81 "disease" controls. Twelve coeliac disease patients on gluten-free diet but with persistent symptoms underwent serum IgA anti-actin antibody assay and intestinal histology evaluation. IgA anti-actin antibody ELISA was performed with a commercial kit. All coeliac disease patients underwent intestinal histology study.Results. IgA anti-actin antibodies showed a sensitivity of 80% and a specificity of 85% in the diagnosis of coeliac disease patients with villous atrophy. The area under the receiving operator curve for anti-actin antibodies was 0.873 [95% C.I. 0.805-0.899]. Serum anti-actin antibodies values were significantly higher in coeliac disease patients than in healthy or "disease" controls (P < 0.0001). Serum anti-actin antibodies were positive in 41 of the 60 coeliac disease patients with mild intestinal histology lesions (69%) and in 123 of the 145 with severe lesions (85.3%) (P < 0.05). There was a significant inverse correlation between anti-actin antibody values and the villi/crypts ratio (r = −0.423; P < 0.0001). In the 12 coeliac disease patients on gluten-free diet who underwent re-evaluation as they were persistently symptomatic, intestinal histology showed three cases with persistent villous atrophy: all of these were positive for serum anti-actin antibodies ELISA, whereas both serum anti-tTG and EmAs were negative. The other nine patients showed normal intestinal villi and were negative for serum anti-actin antibodies.Conclusions. Anti-actin antibodies are a reliable marker of severe intestinal mucosa damage in coeliac disease patients and a simple ELISA technique offers an accurate method for their determination. These antibodies seem to be a very reliable marker of persistent intestinal damage in coeliac disease patients.

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Coeliac disease in the year 2000: exploring the iceberg

Cited by 638 publications

References 15 publications

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Diagnostic efficacy of the ELISA test for the detection of deamidated anti‐gliadin peptide antibodies in the diagnosis and monitoring of celiac disease

IgA anti-actin antibodies ELISA in coeliac disease: A multicentre study

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