IgA antibodies to tissue transglutaminase: An effective diagnostic test for celiac disease

Troncone, Riccardo; Maurano, Francesco; Rossi, Mauro; Micillo, Maria; Greco, Luigi; Auricchio, Renata; Salerno, Giuliana; Salvatore, Francesco; Sacchetti, Lucia

doi:10.1016/s0022-3476(99)70410-5

Cited by 176 publications

(109 citation statements)

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“…Because all serologic tests are based upon assessments of serum IgA (using mucosal antibody against gliadin) and one of the high-risk groups has IgA deficiency, each serology test should be accompanied with a measurement of native IgA at the same time. Sensitivity and specificity of IgA-Ab to tTG has been reported to be sufficiently high to be considered as a diagnostic test in about 80% of situations where obtaining a biopsy is not possible (8,28) . The specificity of the anti-tTG Ab is not significantly different from that of the anti-endomysium antibody, but we prefer it because it requires fewer operators.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…In children who were diagnosed with CD, the average number of samples studied, with standard deviation (s.d.) and range in parenthesis, was 11·8 (Ϯ3·9; [7][8][9][10][11][12][13][14][15][16][17][18][19], and for the children with transient or fluctuating values, 14·1 (Ϯ4·0; [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. At the time of the diagnosis of CD, children were of a mean age of 4·4 (Ϯ1·3; 3·1-6·7) years.…”

Section: Subjectsmentioning

confidence: 99%

Affinity maturation of immunoglobulin A anti-tissue transglutaminase autoantibodies during development of coeliac disease

Westerlund

Ankelo

Simell

et al. 2007

Clinical and Experimental Immunology

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SummaryCoeliac disease (CD) is an immune-mediated enteropathy triggered by ingestion of wheat gluten and related cereals in genetically predisposed individuals. Circulating immunoglobulin A (IgA) class autoantibodies against tissue transglutaminase (IgA-TGA) are highly specific and sensitive serological markers for CD, which is ultimately confirmed by duodenal biopsy. Although CD is considered a life-long disorder, transient or fluctuating IgA-TGA seropositivity has been observed in asymptomatic individuals on a glutencontaining diet. We set out to explore possible differences in the maturation of IgA-TGA avidity between individuals progressing to CD and subjects remaining healthy despite occasional expression of autoantibodies. We developed a time-resolved fluorometric IgA-TGA assay based on human recombinant tissue transglutaminase (tTG), and further modified the method to also measure urea-dependent avidity of the autoantibodies. We measured the autoantibody titres and avidities of sequential serum samples from 10 children developing CD and 10 children presenting transient or fluctuating autoantibodies. Both the initial titres at seroconversion and peak values of transient/fluctuating IgA-TGA were significantly lower than corresponding autoantibody titres in samples drawn from individuals with progressing CD (P = 0·004 and P = 0·0002, respectively). However, there were no statistically significant differences in the initial or peak avidity index values between the two groups of children. The avidity index values increased during the follow-up period (P = 0·013 for both groups) with no significant difference in the rate of avidity maturation between children with transient/fluctuating IgA-TGA and children developing CD. According to our results, high autoantibody titres have a higher predictive value than avidity maturation of TGA-IgA in screening for CD.

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“…23,24 Several methods have been proposed for the detection of humoral anti-tTG immunoreactivity in CD. 20,[25][26][27] The most sensitive assays to detect tTG-Abs were those using human recombinant tTG in a fluid-phase radioimmunoassay (RIA) format. 26,27 Attempts have been made in assaying CD-related Ab in saliva, [28][29][30][31][32][33][34][35] which are easily obtained by noninvasive techniques, bypassing blood sample collection.…”

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confidence: 99%

Tissue transglutaminase autoantibody detection in human saliva: a powerful method for celiac disease screening

Bonamico

Ferri

Nenna

et al. 2004

The Journal of Pediatrics

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Objective To test the possibility of detecting tissue transglutaminase autoantibodies (tTG-Abs) in saliva with a novel sensitive fluid-phase radioimmunoassay (RIA).Study design Paired saliva and serum samples from 39 patients with celiac disease (CD), at the first biopsy (Group 1: 28 females, mean age 11.5 ± 11.1 years); 32 controls with a normal duodenal mucosa (Group 2: 18 females, mean age 8.1 ± 3.6 years); and 32 healthy volunteers (Group 3: 21 females, mean age 31.7 ± 9.8 years) were studied for tTG-Ab presence. Limit of positivity for salivary assay was calculated according to the 99th percentiles of Group 2 control children and was expressed as an autoantibody (Ab) index.Results Salivary tTG-Abs were found in 97.4% of the patients with CD and in 100% of the corresponding serum samples. All Group 3 subjects were negative with both saliva and serum assays. A correlation between saliva and serum tTG-Ab titers was found (r = 0.826, P = .0014).Conclusions This study demonstrates that it is possible to detect salivary tTG-Abs in CD with a non-invasive, simple to perform, reproducible and sensitive method. (J Pediatr 2004;144:632-6) C eliac disease (CD) may appear in a classic presentation, with gastrointestinal complaints and growth failure or with extraintestinal manifestations and ''atypical forms'' 1 characterized by anemia and short stature, 2,3 or with a silent form, more frequent in first-degree relatives of patients with CD. 4 The prevalence of CD is increased in subjects with elevated aminotransferase levels, 5,6 autoimmune diseases, 7,8 and chromosomal aberrations. 9,10 Complications of long-standing CD may include osteopathy, 11 endocrinopathy, 12 infertility, low birth weight infants, 13,14 cancer, 15 and dilated cardiomyopathy and other forms of heart failure. 16 CD has a high prevalence in the general population (0.55% in Italy), often in an asymptomatic form. 17 To reduce the risks associated with prolonged gluten exposure, CD should be diagnosed early, on the basis of the result of one or more intestinal biopsies. 18 Patients with CD receiving a gluten-containing diet have increased levels of anti-gliadin (AGA), anti-endomysium (EMA), 19 and anti-tissue transglutaminase autoantibodies (anti-tTG-Ab). 20 Serum AGA have proved to be effective in the identification of children at risk for CD, but less so in adult screening. 21 EMA are more specific than AGA but are observer-dependent, and sometimes they are not found in children with CD younger than aged 2 years. 19 The recent identification of tTG as the main autoantigen recognized by EMA 22 has lead to the development of various studies that suggest an important role for this enzyme in the etiopathogenesis of CD. 23,24 Several methods have been proposed for the detection of humoral anti-tTG immunoreactivity in CD. 20,[25][26][27] The most sensitive assays to detect tTG-Abs were those using human recombinant tTG in a fluid-phase radioimmunoassay (RIA) format. 26,27 Attempts have been made in assaying CD-related Ab in saliva, [28][29][30][31][32][...

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IgA antibodies to tissue transglutaminase: An effective diagnostic test for celiac disease

Cited by 176 publications

References 10 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

Affinity maturation of immunoglobulin A anti-tissue transglutaminase autoantibodies during development of coeliac disease

Tissue transglutaminase autoantibody detection in human saliva: a powerful method for celiac disease screening

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