Fabbro Elisa, Rubert Laura, Quaglia Sara, Ferrara Fortunato, Kiren Valentina, Ventura Alessandro, Not Tarcisio
Department of Reproductive and Development Science, University of Trieste and I.R.C.C.S. "Burlo Garofolo" Trieste, Italy.
Clin Chim Acta. 2008 Apr;390(1-2):134-7. doi: 10.1016/j.cca.2008.01.015. Epub 2008 Jan 24.
Serum anti-actin IgA antibodies (AAA) were identified in patients with celiac disease (CD), and a close correlation emerged between the presence of AAA and mucosa damage, but test for AAA found in celiacs have a wide range of sensitivity and specificity values.
To compare 1) the sensitivity and specificity of untreated, calcium-chelated and heated sera from 102 celiacs, 52 sick patients and 103 healthy controls in the determination of AAA, and 2) the reliability of AAA with anti-transglutaminase antibodies (anti-tTG) in diagnosing celiac disease and in predicting intestinal damage. The intestinal derived AAA was isolated by using the phage-display library technique.
Treated sera was significantly more sensitive than untreated (p=0.0001), and showed a significant correlation between AAA and the three degrees (3a, 3b, 3c) of intestinal damage (p=0.01). Sensitivity and specificity values of anti-tTG assay were higher than the AAA assay, and anti-tTG serum-concentration was only significantly correlated with more severe (3b and 3c) intestinal damage degrees. AAA isolated by phage display showed similar results of serum AAA in immunofluorescence assay.
Notwithstanding correlation between AAA and celiac disease, AAA assay, also after treatments, has little to offer in screening for CD compared to the well-established anti-transglutaminase assay.
在乳糜泻（CD）患者中发现了血清抗肌动蛋白IgA抗体（AAA），并且AAA的存在与黏膜损伤之间存在密切相关性，但乳糜泻患者中AAA检测的敏感性和特异性值范围很广。
处理后的血清比未处理的血清敏感性显著更高（p = 0.0001），并且AAA与肠道损伤的三个程度（3a、3b、3c）之间存在显著相关性（p = 0.01）。抗tTG检测的敏感性和特异性值高于AAA检测，并且抗tTG血清浓度仅与更严重（3b和3c）的肠道损伤程度显著相关。通过噬菌体展示分离的AAA在免疫荧光检测中显示出与血清AAA相似的结果。
尽管AAA与乳糜泻之间存在相关性，但与成熟的抗转谷氨酰胺酶检测相比，AAA检测（即使在处理后）在乳糜泻筛查中提供的价值不大。
