Liu Edwin, Li Marcella, Emery Lisa, Taki Iman, Barriga Kathy, Tiberti Claudio, Eisenbarth George S, Rewers Marian J, Hoffenberg Edward J
Section of Gastroenterology, Hepatology and Nutrition, The Children's Hospital, and Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA.
J Pediatr Gastroenterol Nutr. 2007 Sep;45(3):293-300. doi: 10.1097/MPG.0b013e31806c7b34.
Gliadin proteins play a key role in the pathogenesis of celiac disease; however, as a screen for celiac disease, anti-gliadin antibody testing has been replaced by the more sensitive and specific serological assays for transglutaminase autoantibodies (TGAA). A new generation of anti-gliadin antibody assays has been developed to detect synthetic, deamidated homologous gliadin peptides (DGP) with high sensitivity and specificity.
Sera were collected prospectively from children with an increased risk for celiac disease as part of an ongoing study at Denver, and studied for the development of celiac autoimmunity. We investigated the high-performance DGP antibody assay in 50 TGAA-positive children both before the development of celiac autoimmunity and following the institution of a gluten-free diet to determine the relationship of DGP antibodies to TGAA. TGAA were measured by an in-house radioassay.
DGP antibodies and TGAA parallel each other over the period of years children were studied. DGP antibodies resolved sooner than TGAA in subjects on a gluten-free diet. DGP antibodies appeared earlier than TGAA in 9 children.
Measuring DGP antibodies may be more useful than TGAA in monitoring children on a gluten-free diet. DGP antibodies can precede the appearance of TGAA in some at-risk children.
麦醇溶蛋白在乳糜泻的发病机制中起关键作用；然而，作为乳糜泻的筛查方法，抗麦醇溶蛋白抗体检测已被更敏感、特异的转谷氨酰胺酶自身抗体（TGAA）血清学检测所取代。新一代抗麦醇溶蛋白抗体检测方法已被开发出来，用于检测具有高敏感性和特异性的合成脱酰胺同源麦醇溶蛋白肽（DGP）。
作为丹佛正在进行的一项研究的一部分，前瞻性收集了乳糜泻风险增加儿童的血清，以研究乳糜泻自身免疫的发展情况。我们在50名TGAA阳性儿童出现乳糜泻自身免疫之前以及采用无麸质饮食之后，对高性能DGP抗体检测进行了研究，以确定DGP抗体与TGAA之间的关系。TGAA通过内部放射免疫测定法进行检测。
在对儿童进行研究的数年期间，DGP抗体和TGAA的变化趋势相互平行。在采用无麸质饮食的受试者中，DGP抗体比TGAA更快消失。在9名儿童中，DGP抗体比TGAA出现得更早。
在监测采用无麸质饮食的儿童时，检测DGP抗体可能比检测TGAA更有用。在一些有风险的儿童中，DGP抗体可能先于TGAA出现。
