Serological Tests in Gluten Sensitivity (Nonceliac Gluten Intolerance)

Volta, Umberto; Tovoli, Francesco; Cicola, Ronny; Parisi, Claudia; Fabbri, Angelo; Piscaglia, Maria; Fiorini, E; Caio, Giacomo

doi:10.1097/mcg.0b013e3182372541

Cited by 220 publications

(238 citation statements)

References 22 publications

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“…All the patients had normal anti-gliadin levels. So far, this is the only candidate marker of such a condition [30]. In this context, the presence of intestinal autoantibodies against TG2 should be assessed.…”

Section: Discussionmentioning

confidence: 99%

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease

Tosco

Aitoro

Auricchio

et al. 2012

Clinical and Experimental Immunology

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SummaryAnti-tissue transglutaminase 2 (anti-TG2) antibodies are present in the serum of the great majority of untreated coeliac disease (CD) patients. They are produced and deposited in the small intestinal mucosa. Potential CD patients present serum anti-TG2 antibodies higher than cut-off, but a normal duodenal mucosa where mucosal deposits of anti-TG2 are not always detectable. The aim of our work was to investigate the presence of anti-TG2 intestinal antibodies in patients with potential CD, and identify the most sensitive test to detect them. Twelve active CD patients, 28 potential CD patients and 39 non-CD controls were enrolled. Biopsy fragments from all patients were analysed by double immunofluorescence to detect mucosal deposits of anti-TG2 antibodies. Fragments from the same subjects were also cultured for 24 h with medium in the presence or absence of gliadin peptides. Anti-TG2 autoantibodies secreted into supernatants were measured by enzyme-linked immunosorbent assay. All active CD, 68% of potential CD patients and 20% of non-CD controls showed mucosal deposits of immunoglobulin (Ig)A anti-TG2; at the same time 100, 96 and 8% of active CD, potential CD and non-CD control patients secreted these antibodies in culture supernatants, respectively. Our data showed that, to detect intestinal anti-TG2 antibodies, the measurement of antibodies secreted into culture supernatants has higher sensitivity and specificity (97·5 and 92·3%, respectively) than the detection of mucosal deposits (77·5 and 80·0%, respectively). The measurement of intestinal anti-TG2 antibodies may prove useful in clinical practice to predict evolution towards mucosal atrophy in potential coeliac patients and identify patients with gluten sensitivity.

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Section: Discussionmentioning

confidence: 99%

Intestinal anti-tissue transglutaminase antibodies in potential coeliac disease

Tosco

Aitoro

Auricchio

et al. 2012

Clinical and Experimental Immunology

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“…Further supportive evidence has come from an Italian group who have reported a high prevalence of IgG gliadin in glutensensitive patients ( n = 44 / 78 or 56.4 % ) ( 45 ). Finally, a recent report of a gluten challenge in a double-blind randomized placebo-controlled study of IBS patients self-controlled on a GFD ( n = 34) suggested that " non-celiac gluten intolerance " may exist ( 46 ).…”

Section: What Evidence Is There To Support the Concept Of Non-celiac Gs?mentioning

confidence: 93%

Editorial: Non-Celiac Wheat Sensitivity: Separating the Wheat from the Chat!

Sanders

Aziz

2012

American Journal of Gastroenterology

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Historically, it has been reported that patients with undetected celiac disease (CD) may present with irritable bowel syndrome (IBS) type symptoms. This has led to the recommendation by the American College of Gastroenterology Task force that patients presenting with diarrhea predominant IBS type symptoms should be serologically tested for CD. Concurrently speculative media data suggest that the US general public have increased their uptake of a gluten-free diet (GFD) far in excess of the known prevalence of CD. This may suggest that individuals with gastrointestinal symptoms are deriving benefi t from a GFD even if they do not have CD. This has led to the scientifi c community considering the evidence for an emerging concept of non-celiac wheat sensitivity. There is a signifi cant disparity in our views about what this phenomenon may be. There is also confusion about the nomenclature for this entity and indeed whether patients are suffering due to symptoms related to gluten or perhaps other components of wheat, for example fructans. In this month ' s edition of the American Journal of Gastroenterology , we see evidence to support the clinical concept of wheat sensitivity or intolerance. Irrespective of the nomenclature Carroccio provides a clinically applicable approach that may be adopted internationally by clinicians. This offers a new option in our armamentarium when seeing patients with IBS type symptoms.

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“…The role of anti-gliadin antibodies (AGA): AGA IgA and IgG have been found in 50% of patients with NCGS [15]; in another study [17] AGA IgG were found at high titre in 56.4% of NCGS patients, while AGA IgA were found in 7.7% of cases.…”

Section: Atis -Amylase Trypsin Inhibitors Non-gluten Derived Proteinsmentioning

confidence: 99%