Servicio de Bioquímica Clínica, Hospital de Navarra, Hospital Virgen del Camino, Pamplona, Spain.
An Esp Pediatr. 2000 Dec;53(6):542-6.
Until now IgA-EmA and IgA-AGA antibodies have been considered to be specific and sensitive markers of celiac disease. Anew antibody, the tissue transglutaminase (IgA-tTG), antibody has recently been identified, which is believed to be if not a better marker then a more practical one in screening for celiac disease, especially in large populations. To evaluate the usefulness of the IgA-tTG antibody in the diagnosis and screening of celiac disease and to determine the relationship between this antibody and other better known and over-used antibodies, antigliadin (IgA-AGA) and antiendomysial (IgA-EmA).
The study was performed in 115 children divided into three groups: 31 patients diagnosed with the celiac disease, according to the ESPGAN criteria; 21 patients with celiac disease following a gluten free diet, and 63 considered as control group. Two enzyme linked immunoabsorbent assays (ELISA) were used to detect AGA and tTG antibodies, respectively. EmA antibodies were determined by using an indirect immunofluorescence technique with commercial sections of distal monkey oesophagus as antigen.
In the 115 patients taken as a whole, the tTG antibody showed 91% agreement with the EmA antibody and 85% agreement with the AGA antibody. In the celiac group, agreement was 84% and 61% respectively. Sensitivity of the tTG antibody was 83% compared with 94% for EmA and 74% for AGA. Specificity was similar in all three tests.
The ELISA test for tTG correlates well with the traditional AGA and EmA tests and could be used as a new test for celiac disease. The procedure is simple and shows high specificity and sensitivity compared with classical EmA and AGA tests and does not involve subjective scoring. It is cheap and very well suited for large scale screening for celiac disease.
迄今为止，IgA-EmA和IgA-AGA抗体一直被视为乳糜泻的特异性和敏感性标志物。最近发现了一种新的抗体，即组织转谷氨酰胺酶（IgA-tTG）抗体，据信它在筛查乳糜泻时即使不是更好的标志物，也是更实用的标志物，尤其是在大规模人群中。为评估IgA-tTG抗体在乳糜泻诊断和筛查中的实用性，并确定该抗体与其他更知名且使用过度的抗体，即抗麦胶蛋白（IgA-AGA）和抗肌内膜（IgA-EmA）之间的关系。
该研究对115名儿童进行，分为三组：31名根据ESPGAN标准诊断为乳糜泻的患者；21名遵循无麸质饮食的乳糜泻患者，以及63名被视为对照组的患者。分别使用两种酶联免疫吸附测定（ELISA）来检测AGA和tTG抗体。通过使用以猴远端食管商业切片为抗原的间接免疫荧光技术来测定EmA抗体。
在总共115名患者中，tTG抗体与EmA抗体的一致性为91%，与AGA抗体的一致性为85%。在乳糜泻组中，一致性分别为84%和61%。tTG抗体的敏感性为83%，而EmA为94%，AGA为74%。所有三项检测的特异性相似。
tTG的ELISA检测与传统的AGA和EmA检测相关性良好，可作为乳糜泻的一种新检测方法。该方法简单，与经典的EmA和AGA检测相比，具有高特异性和敏感性，且不涉及主观评分。它价格便宜，非常适合大规模筛查乳糜泻。
