Scott H, Ek J, Havnen J, Michalsen H, Brunvand L, Howlid H, Brandtzaeg P
Institute of Pathology, University of Oslo, Norway.
J Pediatr Gastroenterol Nutr. 1990 Aug;11(2):215-20.
We examined 1,541 consecutive serum samples from 707 children with suspected food intolerance and 32 with treated celiac disease (CD) for IgG and IgA antibody reactivities to antigens from gluten, egg, and cow's milk by an enzyme-linked immunosorbent assay (ELISA). Samples from 72 patients showed increased IgA and/or IgG reactivity to gluten antigens; four were known CD patients not complying with a gluten-free diet, 13 were suspected CD patients challenged with gluten, and 30 most likely had CD as suggested by small intestinal villous atrophy and histological and/or clinical improvement on a gluten-free diet. The remainder with increased antigluten activity had other disorders that might have affected mucosal permeability. Nevertheless, the median IgA reactivity to gluten was significantly higher in the CD group, and the probability for CD increased from 25 to 100% when this reactivity was above 2.4 optical density (OD) units in our ELISA. Sixteen CD patients (but none of those without CD) had IgA reactivity to gluten higher than 2.4 OD units. We conclude that ELISA determinations of levels of serum antibodies reacting to dietary antigens is a valuable adjunct in the diagnosis of CD in children.
我们通过酶联免疫吸附测定法（ELISA）检测了707名疑似食物不耐受儿童和32名接受治疗的乳糜泻（CD）患者的1541份连续血清样本，以检测其对麸质、鸡蛋和牛奶抗原的IgG和IgA抗体反应性。72名患者的样本显示对麸质抗原的IgA和/或IgG反应性增加；其中4名是已知的未遵循无麸质饮食的CD患者，13名是接受麸质激发试验的疑似CD患者，30名很可能患有CD，这由小肠绒毛萎缩以及无麸质饮食后的组织学和/或临床改善情况表明。其余抗麸质活性增加的患者患有其他可能影响黏膜通透性的疾病。尽管如此，CD组对麸质的IgA反应性中位数显著更高，并且在我们的ELISA中，当这种反应性高于2.4光密度（OD）单位时，CD的可能性从25%增加到100%。16名CD患者（但无CD的患者中无人）对麸质的IgA反应性高于2.4 OD单位。我们得出结论，ELISA测定血清中对饮食抗原反应的抗体水平是儿童CD诊断中有价值的辅助手段。
