Ankelo M, Kleimola V, Simell S, Simell O, Knip M, Jokisalo E, Tarkia M, Westerlund A, He Q, Viander M, Ilonen J, Hinkkanen A E
Department of Biochemistry and Pharmacy, Abo Akademi University, Turku, Finland.
Clin Exp Immunol. 2007 Nov;150(2):285-93. doi: 10.1111/j.1365-2249.2007.03487.x. Epub 2007 Sep 4.
Coeliac disease (CD) is an enteropathy induced in genetically susceptible individuals by gluten components, gliadin, hordein and secalin, polypeptides present in cereals such as wheat, barley and rye, respectively. Although the disease starts as intolerance to gliadins, antibodies to tissue transglutaminase (tTG) in the gut epithelium are characteristic of the disease. Whereas serum autoantibodies against tTG (tTGA) are highly specific for CD, antibodies to gliadin are less informative as they can also be detected in other enteropathies, and even in healthy individuals. However, it was shown recently that antibodies to certain gliadin peptides occur with high specificity in CD patient sera. We developed a solid phase lanthanide-based immunofluorometric assay for simultaneous detection of serum IgA and IgG antibodies to a synthetic peptide derived from gamma gliadin of wheat comprising amino acids 86-103. Three glutamine residues of this native 18-mer peptide were replaced by glutamic acids and the peptide was biotinylated. Sera from 87 individuals who had undergone duodenal biopsy and were diagnosed with CD and from 81 healthy individuals were analysed for the presence of both IgA and IgG anti-gliadin peptide antibodies. The performance of the peptide AGA assay was excellent, showing a specificity and sensitivity of 90% and 92% for IgA, and 98% and 75% for IgG, respectively. The corresponding values for conventional anti-gliadin antibody (AGA) enzyme-linked immunosorbent assay (ELISA) tests were 72% specificity and 87% sensitivity for IgA, and 64% specificity and 78% sensitivity for IgG. In a prospective study, almost all the tTGA-positive sera drawn from children who later developed CD were also positive for gliadin peptide antibodies.
乳糜泻(CD)是一种由麸质成分、麦醇溶蛋白、大麦醇溶蛋白和黑麦醇溶蛋白(分别存在于小麦、大麦和黑麦等谷物中的多肽)在遗传易感个体中诱发的肠病。尽管该病始于对麦醇溶蛋白的不耐受,但肠道上皮组织转谷氨酰胺酶(tTG)抗体是该疾病的特征。虽然血清中抗tTG(tTGA)自身抗体对CD具有高度特异性,但麦醇溶蛋白抗体的诊断价值较低,因为它们也可在其他肠病甚至健康个体中检测到。然而,最近研究表明,某些麦醇溶蛋白肽抗体在CD患者血清中具有高特异性。我们开发了一种基于镧系元素的固相免疫荧光测定法,用于同时检测血清中针对源自小麦γ-麦醇溶蛋白、包含86-103位氨基酸的合成肽的IgA和IgG抗体。该天然18肽的三个谷氨酰胺残基被谷氨酸取代,并对该肽进行了生物素化。对87例接受十二指肠活检并被诊断为CD的个体以及81例健康个体的血清进行分析,检测其中IgA和IgG抗麦醇溶蛋白肽抗体的存在情况。该肽麦醇溶蛋白抗体检测法性能优异,IgA的特异性和敏感性分别为90%和92%,IgG的特异性和敏感性分别为98%和75%。传统抗麦醇溶蛋白抗体(AGA)酶联免疫吸附测定(ELISA)检测的相应值为,IgA的特异性为72%,敏感性为87%;IgG的特异性为64%,敏感性为78%。在一项前瞻性研究中,几乎所有后来发展为CD的儿童所采集的tTGA阳性血清中,麦醇溶蛋白肽抗体也呈阳性。
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