Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere, Finland.
J Clin Immunol. 2011 Jun;31(3):436-42. doi: 10.1007/s10875-011-9514-x. Epub 2011 Mar 9.
The autoantigen of celiac disease, transglutaminase 2 (TG2), adopts an open conformation during enzymatic activation. We studied diagnostic accuracy of serodiagnostic assays using TG2 in its open and closed conformation as antigens in patients with diagnostic difficulties. The open TG2 antibody (TG2ab) test identified 93% of untreated celiac patients in contrast to 44%, 27%, and 68% detected by closed and conventional TG2ab and endomysial antibody (EmA) tests, respectively. The assay was able to detect 60% of non-responding celiac patients seronegative for conventional TG2ab and EmA. The titers of the open TG2abs were higher than those of the closed TG2abs. The serological test utilizing TG2 in an open conformation was more accurate than the other assays in finding active celiac disease even in patients having negative or borderline conventional celiac autoantibodies and in revealing poor dietary response non-invasively. It thus offers a promising tool in the diagnostics and follow-up of celiac disease.
自身免疫性疾病的自身抗原，转谷氨酰胺酶 2（TG2），在酶激活过程中采用开放构象。我们研究了使用 TG2 的开放和封闭构象作为抗原的诊断困难患者的血清学诊断准确性。与传统 TG2ab 和 EmA 检测分别检测到的 44%、27%和 68%相比，开放 TG2ab 检测可识别 93%未经治疗的乳糜泻患者。该检测能够检测到 60%对传统 TG2ab 和 EmA 检测呈阴性的无反应性乳糜泻患者。开放 TG2ab 的滴度高于封闭 TG2ab。与其他检测方法相比，利用开放构象的 TG2 进行血清学检测在发现活动性乳糜泻方面更准确，即使在常规乳糜泻自身抗体阴性或边界性的患者中，以及在非侵入性地揭示不良饮食反应方面也更准确。因此，它为乳糜泻的诊断和随访提供了一种有前途的工具。
