Conrad Karsten, Roggenbuck Dirk, Ittenson Annelore, Reinhold Dirk, Buettner Thomas, Laass Martin W
Institute of Immunology, Technical University Dresden, Dresden, Germany.
Clin Chem Lab Med. 2012 Feb;50(2):337-43. doi: 10.1515/cclm.2011.760.
This study investigated whether a dot immunoassay (DIA) can provide simultaneous detection of anti-tissue transglutaminase (tTG), anti-deamidated gliadin (DG) and total IgA antibodies, as required in the work-up of celiac disease (CD) patients.
Celiac disease patients (n=111) consecutively diagnosed from 2001 to 2011 at the Children's Hospital and Institute of Immunology (Technical University Dresden) were tested for anti-tTG, anti-DG and total IgA by enzyme-linked immunosorbent assay (ELISA) and DIA retrospectively. Blood donors (n=45) and non-CD individuals with low IgA serum levels (n=8) were included as controls. Antibodies to endomysial antigens (EmA) were assessed by indirect immunofluorescence (IIF).
Four (3.6%) of 111 CD patients demonstrated an IgA deficiency with total IgA below 50 mg/L by ELISA. Total IgA of the 107 IgA-non-deficient CD patients varied from 70 to 6000 mg/L. All four IgA-deficient CD patients were detected by a reduced reaction control of DIA and demonstrated positive anti-tTG or anti-DG IgG by DIA or ELISA. Detection of anti-tTG and anti-DG by DIA and ELISA showed a very good agreement (IgA: κ=0.972, 0.856, respectively; IgG: 0.921, 0.895, respectively).
Immunodot assay is a reliable and easy-to-use technique for the detection of IgA-deficient CD patients. Simultaneous assessment of anti-tTG and anti-DG IgA antibodies, and IgA deficiency by DIA can improve the efficacy of CD serology.
本研究调查了斑点免疫测定法（DIA）是否能够如乳糜泻（CD）患者检查工作中所要求的那样，同时检测抗组织转谷氨酰胺酶（tTG）、抗脱酰胺麦醇溶蛋白（DG）和总IgA抗体。
对2001年至2011年在儿童医院和免疫研究所（德累斯顿工业大学）连续诊断的乳糜泻患者（n = 111）进行回顾性检测，通过酶联免疫吸附测定法（ELISA）和DIA检测抗tTG、抗DG和总IgA。纳入献血者（n = 45）和低IgA血清水平的非CD个体（n = 8）作为对照。通过间接免疫荧光法（IIF）评估抗肌内膜抗原（EmA）抗体。
111例CD患者中有4例（3.6%）通过ELISA显示IgA缺乏，总IgA低于50 mg/L。107例IgA非缺乏的CD患者的总IgA在70至6000 mg/L之间。所有4例IgA缺乏的CD患者均通过DIA的反应对照降低检测到，并通过DIA或ELISA显示抗tTG或抗DG IgG阳性。DIA和ELISA检测抗tTG和抗DG显示出非常好的一致性（IgA：κ分别为0.972、0.856；IgG：分别为0.921、0.895）。
免疫斑点测定法是检测IgA缺乏的CD患者的可靠且易于使用的技术。通过DIA同时评估抗tTG和抗DG IgA抗体以及IgA缺乏可提高CD血清学的效能。
