Volta Umberto, Granito Alessandro, Fiorini Erica, Parisi Claudia, Piscaglia Maria, Pappas Georgios, Muratori Paolo, Bianchi Francesco B
Department of Gastroenterology and Internal Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, Bologna 40138, Italy.
Dig Dis Sci. 2008 Jun;53(6):1582-8. doi: 10.1007/s10620-007-0058-0.
The prevalence of the recently described deamidated gliadin peptide antibodies was compared with that of the routinely used antigliadin, antiendomysial, and tissue transglutaminase antibodies in the sera of 128 untreated celiac patients and 134 controls. Sensitivity and specificity for celiac disease were 83.6 and 90.3% for IgA and 84.4 and 98.5% for IgG antibodies to deamidated gliadin peptides. The new test displayed higher diagnostic accuracy than antigliadin antibodies and, although less sensitive than antiendomysial and tissue transglutaminase antibodies, showed significantly higher specificity than tissue transglutaminase antibodies (P < 0.001). Persistence of peptide antibodies after gluten withdrawal was an expression of low compliance with the diet and of the lack of improvement of the intestinal mucosa. The combined use of tissue transglutaminase and deamidated gliadin peptide antibodies seems to be a very useful tool for celiac disease diagnosis. Moreover, antibodies to deamidated gliadin peptides can be helpful in disease follow-up.
在128例未经治疗的乳糜泻患者和134例对照者的血清中，比较了最近描述的脱酰胺麦醇溶蛋白肽抗体的流行率与常规使用的抗麦醇溶蛋白抗体、抗肌内膜抗体和组织转谷氨酰胺酶抗体的流行率。针对脱酰胺麦醇溶蛋白肽的IgA抗体对乳糜泻的敏感性和特异性分别为83.6%和90.3%，IgG抗体分别为84.4%和98.5%。这项新检测显示出比抗麦醇溶蛋白抗体更高的诊断准确性，并且虽然比抗肌内膜抗体和组织转谷氨酰胺酶抗体敏感性低，但比组织转谷氨酰胺酶抗体具有显著更高的特异性（P < 0.001）。停用麸质后肽抗体持续存在表明对饮食的依从性差以及肠黏膜缺乏改善。联合使用组织转谷氨酰胺酶和脱酰胺麦醇溶蛋白肽抗体似乎是诊断乳糜泻的非常有用的工具。此外，脱酰胺麦醇溶蛋白肽抗体有助于疾病的随访。
