Vitoria J C, Arrieta A, Arranz C, Ayesta A, Sojo A, Maruri N, García-Masdevall M D
Department of Pediatrics, Hospital de Cruces and Basque University School of Medicine, Bilbao, Spain.
J Pediatr Gastroenterol Nutr. 1999 Nov;29(5):571-4. doi: 10.1097/00005176-199911000-00018.
Tissue transglutaminase has recently been identified as the main autoantigen recognized by antiendomysial antibodies in celiac disease. Serum immunoglobulin (Ig)A antibodies to tissue transglutaminase (tTG-ab) determined by an enzyme-linked immunosorbent assay (ELISA) technique have been reported to correlate closely with IgA antiendomysial antibodies (EMA). The purpose of this study was to assess the sensitivity, specificity, and predictive value of tTG-ab measured by a commercially available ELISA technique, compared with those of EMA and IgA antigliadin antibodies (AGA) for the diagnosis of celiac disease.
Twenty-seven serum samples were obtained from patients with untreated celiac disease, 37 from patients who had had gluten withdrawn from their diets for varying time spans, and 34 from control subjects without celiac disease. All were younger than 14 years. Presence of tTG-ab and AGA was determined by ELISA and of EMA by indirect immunofluorescence.
Twenty-six of 27 serum samples obtained from patients at the time of diagnosis of celiac disease were AGA positive. All 27 (concordance rate 100%) were positive for EMA and tTG-ab. Of the 34 control subjects, 1 was for AGA and 2 for tTG-ab. All 34 were negative for EMA. Sensitivity, specificity, positive predictive value, and negative predictive value within this group were, for tTG-ab: 100%, 94%, 93%, and 100%, respectively; for EMA: all four indexes were 100%; and for AGA: 96%, 97%, 96%, and 97%, respectively. Of the 37 with treated celiac disease, 2 were AGA positive, 9 were EMA positive, and 6 were tTG-ab positive. The concordance rate between EMA and tTG-ab was 100% in the group with untreated celiac disease, 94% in the control subjects, and 76% in the group with treated celiac disease.
Immunoglobulin A antibodies to tissue transglutaminase are new, highly sensitive, and specific markers of celiac disease. They can be determined easily by an accurate, comparatively cheap technique and thereby may advantageously replace the EMA marker traditionally used.
组织转谷氨酰胺酶最近被确定为乳糜泻中抗肌内膜抗体识别的主要自身抗原。据报道，通过酶联免疫吸附测定（ELISA）技术测定的血清抗组织转谷氨酰胺酶免疫球蛋白（Ig）A抗体（tTG-ab）与IgA抗肌内膜抗体（EMA）密切相关。本研究的目的是评估通过市售ELISA技术测量的tTG-ab与EMA和IgA抗麦胶蛋白抗体（AGA）相比，在乳糜泻诊断中的敏感性、特异性和预测价值。
从未经治疗的乳糜泻患者中获取27份血清样本，从饮食中去除麸质不同时间的患者中获取37份血清样本，从无乳糜泻的对照受试者中获取34份血清样本。所有患者年龄均小于14岁。通过ELISA测定tTG-ab和AGA的存在情况，通过间接免疫荧光测定EMA的存在情况。
在乳糜泻诊断时从患者获得的27份血清样本中，26份AGA呈阳性。所有27份样本（符合率100%）EMA和tTG-ab均呈阳性。在34名对照受试者中，1名AGA呈阳性，2名tTG-ab呈阳性。所有34名对照受试者EMA均为阴性。该组中tTG-ab的敏感性、特异性、阳性预测值和阴性预测值分别为100%、94%、93%和100%；EMA的所有四项指标均为100%；AGA的分别为96%、97%、96%和97%。在37名接受治疗的乳糜泻患者中，2名AGA呈阳性，9名EMA呈阳性，且6名tTG-ab呈阳性。未经治疗的乳糜泻组中EMA和tTG-ab的符合率为100%，对照受试者中为94%，接受治疗的乳糜泻组中为76%。
抗组织转谷氨酰胺酶免疫球蛋白A抗体是乳糜泻新的、高度敏感且特异的标志物。它们可以通过准确、相对便宜的技术轻松测定，因此可能有利地取代传统使用的EMA标志物
