Vecchi M D M, Folli C, Donato M F, Formenti S, Arosio E, Franchis R de
a Gastroenterology Unit, Dept. of Internal Medicine and Liver Unit, IRCCS Policlinico Hospital and University of Milan, Italy.
b Gastroenterology Unit, Dept. of Internal Medicine, Via Pace 9, IT-20122 Milano, Italy (fax. +39 02 5501 5818, e-mail.
Scand J Gastroenterol. 2003 Jan;38(1):50-54. doi: 10.1080/00365520310000438.
Since the recognition of tissue transglutaminase (tTG) as the target antigen of anti-endomysium antibodies, several ELISA assays using either guinea pig or human recombinant tTG have been developed. The aim of the study was to compare the behaviour of anti-tTG and anti-endomysium antibodies assays in coeliacs and in patients with chronic liver disease.
34 patients (24 women, 34.9 ± 12.5 years) with coeliac disease and 41 with chronic liver disease (14 women, 57 ± 11.2 years), including 19 cirrhotics, were evaluated for anti-endomysium antibodies by indirect immunofluorescence and for anti-tTG IgA antibodies by ELISA, using guinea pig liver or human recombinant transglutaminase.
The prevalences of anti-tTG and anti-endomysium antibodies were 100% in patients with coeliac disease at diagnosis, 75% and 64.3% in patients on a gluten-free diet. All liver disease patients were negative for anti-endomysium antibodies, while 11 (26.8%) were positive for anti-tTG. All these patients had liver cirrhosis and represented 57.9% of all cirrhotics. The presence of anti-tTG was associated with higher Child-Pugh scores. The use of human transglutaminase determined a reduction in the rate of positive results; however, the rate of positive anti-tTG was still 17.1% in all liver disease patients and 31.6% in cirrhotics.
Our data confirm that anti-tTG have a similar sensitivity compared with anti-endomysium antibodies assay in coeliacs. However, a high prevalence of positive anti-tTG results is observed in cirrhotic patients, even when human recombinant tTG is used. The high prevalence of positive results among cirrhotic patients is associated with more advanced liver disease.
自从组织转谷氨酰胺酶（tTG）被确认为抗肌内膜抗体的靶抗原以来，已经开发了几种使用豚鼠或人重组tTG的ELISA检测方法。本研究的目的是比较乳糜泻患者和慢性肝病患者中抗tTG和抗肌内膜抗体检测的表现。
对34例乳糜泻患者（24名女性，年龄34.9±12.5岁）和41例慢性肝病患者（14名女性，年龄57±11.2岁，其中19例为肝硬化患者）进行评估，通过间接免疫荧光法检测抗肌内膜抗体，通过ELISA法使用豚鼠肝或人重组转谷氨酰胺酶检测抗tTG IgA抗体。
诊断时乳糜泻患者中抗tTG和抗肌内膜抗体的患病率为100%，无麸质饮食患者中分别为75%和64.3%。所有肝病患者抗肌内膜抗体均为阴性，而11例（26.8%）抗tTG为阳性。所有这些患者均患有肝硬化，占所有肝硬化患者的57.9%。抗tTG的存在与较高的Child-Pugh评分相关。使用人转谷氨酰胺酶可降低阳性结果率；然而，所有肝病患者中抗tTG阳性率仍为17.1%，肝硬化患者中为31.6%。
我们的数据证实，在乳糜泻患者中，抗tTG与抗肌内膜抗体检测具有相似的敏感性。然而，即使使用人重组tTG，肝硬化患者中抗tTG阳性结果的患病率也很高。肝硬化患者中阳性结果的高患病率与更严重的肝病相关。
