一种改良的酶联免疫吸附测定法，用于提高乳糜泻中抗组织转谷氨酰胺酶抗体IgA、IgG和IgM的检测水平。

A modified ELISA for improved detection of IgA, IgG, and IgM anti-tissue transglutaminase antibodies in celiac disease.

作者信息

Teesalu Kaupo, Agardh Daniel, Panarina Marina, Utt Meeme, Uibo Oivi, Uibo Raivo

机构信息

Immunology group, Department of General and Molecular Pathology, University of Tartu, Tartu, Estonia.

出版信息

Clin Chim Acta. 2009 May;403(1-2):37-41. doi: 10.1016/j.cca.2009.01.006.

DOI:10.1016/j.cca.2009.01.006

PMID:19408348

Abstract

BACKGROUND

Serum IgA antibodies against tissue transglutaminase (tTG) are reliable markers for celiac disease (CD), still the diagnostic performance of anti-tTG immunoassays can be improved. A novel ELISA, using fibronectin (FN) as tTG binding protein, was evaluated for the detection of anti-tTG antibodies in CD.

METHODS

Sera from 173 children with untreated CD and 97 controls were analyzed for IgA, IgG, and IgM anti-tTG antibodies with ELISA using human recombinant tTG with or without FN.

RESULTS

The areas under the ROC (receiver operating characteristic) curves were significantly higher for FN/tTG ELISA compared to tTG ELISA for IgG (0.930 versus 0.809; p < 0.001) and IgM (0.850 versus 0.811; p = 0.019), but not for IgA (0.977 versus 0.970; p = 0.356), respectively. At the fixed diagnostic specificity (100% for IgA and IgM, 99% for IgG), the sensitivity of all three FN/tTG ELISA (92.5% for IgA, 60.7% for IgG, 50.3% for IgM) exceeded those obtained in tTG ELISA (89.0% for IgA, 48.6% for IgG, 38.7% for IgM; p < 0.05). The combined use of IgA- and IgG-FN/tTG ELISA resulted in 95.4% sensitivity and 99.0% specificity for CD.

CONCLUSIONS

Using FN to bind tTG improves the diagnostic performance of solid phase anti-tTG antibody assays for childhood CD.

摘要

背景

血清抗组织转谷氨酰胺酶（tTG）IgA抗体是乳糜泻（CD）的可靠标志物，但抗tTG免疫测定的诊断性能仍可提高。一种使用纤连蛋白（FN）作为tTG结合蛋白的新型酶联免疫吸附测定（ELISA），用于检测CD患者血清中的抗tTG抗体。

方法

采用人重组tTG，有无FN参与，用ELISA分析173例未经治疗的CD患儿和97例对照的血清中IgA、IgG和IgM抗tTG抗体。

结果

与tTG ELISA相比，FN/tTG ELISA检测IgG（0.930对0.809；p<0.001）和IgM（0.850对0.811；p=0.019）的受试者工作特征（ROC）曲线下面积显著更高，但检测IgA时（0.977对0.970；p=0.356）并非如此。在固定诊断特异性（IgA和IgM为100%，IgG为99%）时，所有三种FN/tTG ELISA的敏感性（IgA为92.5%，IgG为60.7%，IgM为50.3%）均超过tTG ELISA（IgA为89.0%，IgG为48.6%，IgM为38.7%；p<0.05）。联合使用IgA-和IgG-FN/tTG ELISA诊断CD的敏感性为95.4%，特异性为99.0%。