The relationship between anti-endomysium antibodies and villous atrophy in coeliac disease using both monkey and human substrate

Rostami, Kamran; Kerckhaert, J.; Tiemessen, R.; Meijer, Jos W. R.; Mulder, Chris J.

doi:10.1097/00042737-199904000-00013

Cited by 67 publications

(41 citation statements)

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“…Establishing a correlation between positive serology and small bowel histopathology has considerable clinical utility. We observe a significant correlation between Marsh III histopathology and positive tTGA/EMA serology, as reported by other studies [23]. Presence of EMA or tTGA in our study was significantly associated with more severe villous atrophy.…”

Section: Discussionsupporting

confidence: 91%

“…Sensitivity of serological testing is questionable among patients presenting with PVA, thus reducing its effectiveness in clinical practice [12,18,19,22]. Rostami et al [23] show that EMA has a lower sensitivity in CD patients with milder intestinal damage. Tursi et al [18] observe, in 119 adults, that the prevalence of tTGA seropositivity and the mean tTGA titer are higher in CD patients with more severe inflammation at biopsy.…”

Section: Discussionmentioning

confidence: 99%

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Serology in adults with celiac disease: limited accuracy in patients with mild histological lesions

et al. 2011

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Celiac disease (CD) is a gluten-triggered enteropathy, presenting with insidious clinical patterns. It can occasionally be diagnosed in asymptomatic subjects. Our aim was to define the relationship among symptoms at diagnosis, serological markers [tissue transglutaminase antibodies (tTGA), anti-endomysium antibodies (EMA) anti-actin antibodies (AAA)] and degree of mucosal damage. A total of 68 consecutive adult patients with CD were enrolled. Intestinal biopsies were scored according to the Marsh classification modified by Oberhuber: I-II minimal lesions or absent villous atrophy; IIIA partial villous atrophy; IIIB-C total villous atrophy (TVA). HLA-typing was done for all patients. No association between clinical presentation and severity of mucosal damage was found. Presence of EMA or tTGA was significantly associated with more severe mucosal damage (P \ 0.001). Of 12 patients, 11 with AAA were also positive for TVA. The severity of mucosal damage is the main factor governing the detectability of serological markers of CD. The sensitivity of serological testing is questionable in patients with minimal lesions.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Serology in adults with celiac disease: limited accuracy in patients with mild histological lesions

et al. 2011

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“…The first aspect seems to be fully confirmed by recent reviews showing that serum IgA EmA antibodies have 90%-100% sensitivity and 95%-100% specificity and that IgA anti-tTG antibodies show very similar values (14,15 ), mainly obtained with the second-generation, human anti-tTG assays (9,16 ). However, the presence of positive serum antibodies has been shown to correlate with the degree of villous atrophy, and CD patients with less severe histologic damage can be seronegative for CD (17)(18)(19)(20). It has been demonstrated previously that the culture medium of intestinal biopsy specimens from some of these CD patients showed positive EmA antibodies, and this positivity can be useful for CD diagnosis in patients with minimal intestinal histologic lesions (8,21 ).…”

Section: Discussionmentioning

confidence: 75%

“…Histologic findings and the clinical follow-up confirmed that 162 of the 166 patients positive for serum EmA and/or anti-TG antibodies had CD. The other 4 patients (1 positive for EmA and anti-tTG antibodies, and 3 positive only for anti-tTG antibodies) in whom CD diagnosis was excluded showed a normal duodenal histology, with a villi/crypts ratio Ͼ3.5 and Ͻ30 IELs/100 epithelial cells (range, [12][13][14][15][16][17][18][19][20].…”

Section: Final Diagnoses In the Study Groupmentioning

confidence: 99%

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Carroccio¹,

Prima²,

Pirrone³

et al. 2006

Clinical Chemistry

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Background:We measured anti-transglutaminase (antitTG) antibody in the culture medium of intestinal biopsy specimens from patients with suspected celiac disease (CD) and evaluated the relationship between antibody production and severity of intestinal mucosal damage. Methods: We performed diagnostic testing for CD on 273 consecutive patients. In addition to routine histologic evaluation of duodenal biopsy specimens, we assayed anti-tTG antibodies in serum and in the culture medium of duodenal biopsy specimens. Results: CD was diagnosed in 191 of the 273 patients. Sensitivity and specificity of the serum anti-endomysium (EmA) and anti-tTG assays were 83% and 85% and 99% and 95%, respectively, and both had 88% diagnostic accuracy. EmA and anti-tTG assayed in the culture medium had 98% sensitivity, 100% specificity, and 98% diagnostic accuracy (vs serum assays; P <0.0001). Twenty-nine CD patient specimens (16%) were negative for serum anti-tTG and EmA; for 24 of these patients, anti-tTG assay of the culture medium was positive. The CD patients whose biopsy specimens were positive for serum antibodies showed the following intestinal histologies: total villous atrophy, 35%; severe villous atrophy, 25%; mild atrophy, 25%; villi with no atrophy but with increased intraepithelial lymphocytes, 15%. None

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“…En general, los AEm-IgA parecen ser más específicos y los aTGt más sensibles, especialmente los que utilizan el antígeno recombinante humano 58 . Sin embargo, se ha observado una pérdida de sensibilidad en los casos de lesiones menores en la biopsia y pueden encontrarse casos de AEm-IgA negativos en un 69% de los pacientes adultos con alteraciones parciales (Marsh IIIa) 59 . Un patrón similar, aunque con mejores valores, se ha observado también para los aTGt-IgA 60 .…”

Section: Marcadores Serológicosunclassified

Inmunología de la enfermedad celíaca

Arranz

Garrote

2010

Gastroenterología y Hepatología

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PALABRAS CLAVEEnfermedad celíaca; Linfocitos T; Péptidos de gluten; HLA-DQ2/DQ8; Transglutaminasa; Citocinas; Anticuerpos Resumen La enfermedad celíaca es un trastorno inflamatorio del intestino delgado inducido por la ingestión de gluten de trigo y otras prolaminas en individuos genéticamente susceptibles, que se manifiesta por linfocitosis intraepitelial y de lámina propia, pérdida de vellosidades, remodelación tisular y presencia de anticuerpos antitransglutaminasa. El modelo patogénico más aceptado depende de la inmunidad adaptativa tras la estimulación de linfocitos T CD4 þ por péptidos de gluten modificados por la transglutaminasa tisular y restricción por moléculas HLA-DQ2/DQ8, que producen citocinas proinflamatorias. El gluten activa también la inmunidad innata y la citotoxicidad epitelial mediada por linfocitos intraepiteliales. Aunque no está claro aún cuál es el efecto de los anticuerpos específicos, la disponibilidad de marcadores serológicos e inmunogenéticos como herramientas diagnósticas ha propiciado el avance en el conocimiento de la enfermedad celíaca y la revisión de los criterios diagnósticos, especialmente en los individuos adultos con expresión mínima o atípica de la enfermedad. & 2009 Elsevier España, S.L. Todos los derechos reservados. KEYWORDSCeliac disease; T lymphocytes; Gluten peptides; HLA-DQ2/DQ8; Transglutaminase; Cytokines; Antibodies Immunology of celiac disease AbstractCeliac disease is an inflammatory disorder of the small intestine induced by intake of wheat gluten and other prolamines in genetically susceptible individuals. This disease is manifested by an increased number of intraepithelial and lamina propria lymphocytes, villous atrophy, tissue remodeling and the presence of anti-transglutaminase antibodies. The most widely accepted pathogenic model is based on adaptive immunity after T CD4 þ lymphocyte stimulation by tissue transglutamine-modified gluten peptides and HLA-DQ2/DQ8 restriction, which produce proinflammatory cytokines. Gluten also activates innate immunity and epithelial cytotoxicity mediated by intraepithelial lymphocytes. Although the effect of specific antibodies remains unclear, the 0210-5705/$ -see front matter & 2009 Elsevier España, S.L. Todos los derechos reservados.

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The relationship between anti-endomysium antibodies and villous atrophy in coeliac disease using both monkey and human substrate

Cited by 67 publications

References 0 publications

Serology in adults with celiac disease: limited accuracy in patients with mild histological lesions

Serology in adults with celiac disease: limited accuracy in patients with mild histological lesions

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimens Can Improve the Accuracy of Celiac Disease Diagnosis

Inmunología de la enfermedad celíaca

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