Reliability of the Multiplex CytoBead CeliAK Immunoassay to Assess Anti-tTG IgA for Celiac Disease Screening

Abstract

Background and Objective: The diagnosis of Celiac Disease (CD) is first based on the positivity for specific serological markers. The CytoBead CeliAK immunoassay simultaneously measures antibodies (IgA) directed to tissue transglutaminase (tTG), endomysium (EMA), and deamidated gliadin (DG), in addition to providing a control for total IgA levels. The aim of this study is to assess the reliability of this multiplex assay to detect anti-tTG IgA positive patients, compared with a conventional single-parameter enzyme-linked immunosorbent assay (ELISA).Methods: Serum samples from 149 pediatric patients were assessed by both CytoBead CeliAK immunoassay and ELISA, in order to evaluate their concordance for the measurement of anti-tTG IgA.Results: The measurement of anti-tTG IgA by CytoBead CeliAK immunoassay basically showed a complete concordance rate with the conventional and single-parameter ELISA, according to the respective cutoff values (3 U/ml and 10 U/ml).Conclusions: Our comparative analysis demonstrates a substantial equivalency between multiplex CytoBead CeliAK assay and the single-parameter conventional ELISA to assess anti-tTG IgA antibody in the context of the screening for CD in children. Importantly, CytoBead CeliAK assay could present some preanalytic, analytic, and economic advantages.

Celiac Disease in Uzbek Children: Insights into Disease Prevalence and Clinical Characteristics in Symptomatic Pediatric Patients

“…Therefore, the significant prevalence of CD that we found among symptomatic Uzbek children, in addition to the aforementioned immunogenetic considerations, suggests that the prevalence of pediatric CD may be similar to that observed in Europe, also considering the relevant consumption of wheat [22,23]. This expectation is further supported by the previous observations of 6-7% anti-tTG IgA seropositivity in at-risk pediatric patients from Kazakhstan [24], and by the fact that significant barriers to CD diagnosis still exist in Central Asia [5], in addition to the previous observations coming from Uzbekistan as well [25,26].…”

“…Conversely, in most developed countries, in children, the clinical pattern of CD has been gradually shifting to a more frequent atypical presentation, where CD presenting with classical gastrointestinal forms is promptly recognized and more attention is paid to extra-gastrointestinal symptoms potentially associated with atypical CD [36,37]. At the same time, these observations further point out the fact that many pediatric patients with CD may not be diagnosed in Uzbekistan due to poor medical awareness and/or diagnostic investigation in children with atypical forms [38], as already reported in other countries of Central Asia [5,24] and in other developing countries [4,[39][40][41].…”

Celiac Disease in Juvenile Idiopathic Arthritis and Other Pediatric Rheumatic Disorders

“…Notably, these studies adopted an incomplete CD screening strategy: indeed, Khoene et al and Nisihara et al, respectively, performed the serological screening by using anti-gliadin antibody(AGA)/anti-endomysia antibody (EmA) and EmA/anti-tissue transglutaminase IgG (tTG IgG), which are not the most sensitive serological markers for CD [17,21]. Currently, anti-tissue transglutaminase IgA (tTG IgA) is considered the most accurate serological marker (in terms of both sensitivity and specificity) for CD in children [11,29,30]. Sahin [18,20,24]; however, some patients may be positive for EmA only (and tTG-IgA negative, at least in the initial stage of disease) [5,31,32] and, therefore, a cross-sectional study where EmA or tTG IgA are not used together may have lost these CD patients, even if they are very few.…”