Di Tola Marco, Marino Mariacatia, Casale Rossella, Borghini Raffaele, Tiberti Antonio, Donato Giuseppe, Occhiuzzi Umberto, Picarelli Antonio
Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy.
Department of Biomedical Services-UOC Laboratory Analysis Marsica/Peligno/Sangrina Area, ASL 1 Avezzano Sulmona L'Aquila, Avezzano AQ, Italy.
J Clin Lab Anal. 2018 Jan;32(1). doi: 10.1002/jcla.22195. Epub 2017 Mar 9.
Anti-tissue transglutaminase (anti-tTG) and endomysium antibodies (EMA) are detectable in duodenal culture media of celiac disease (CD) patients. To improve the management of this organ culture system, we evaluated the anti-tTG occurrence by immunochromatographic assay (ICA).
A total of 103 CD patients and 41 disease controls underwent duodenal biopsy for the organ culture. In culture supernatants, IgA anti-tTG were tested by both enzyme-linked immunosorbent assay (ELISA) and ICA, IgA EMA were searched by indirect immunofluorescence analysis (iIFA).
Endomysium antibodies and anti-tTG measured by ELISA were positive in culture media of all CD patients, while anti-tTG detected by ICA were positive in culture media of 87/103 CD patients. Anti-tTG ICA scores significantly correlated with anti-tTG ELISA values (r=.71, P<.0001). Sensitivity, specificity and diagnostic accuracy of anti-tTG detected by ICA were 84.5%, 100% and 88.9%, respectively.
Using ICA, anti-tTG are detectable in duodenal culture media of most CD patients and the intensity of indicative lines depends on the anti-tTG concentration. Sensitivity and diagnostic accuracy achieved with ICA are lower than those obtained with ELISA but, given that the first is a more easy and prompt method, data suggest the possibility of utilizing it in the in vitro diagnosis of CD.
在乳糜泻(CD)患者的十二指肠培养基中可检测到抗组织转谷氨酰胺酶(抗tTG)和肌内膜抗体(EMA)。为了改进这种器官培养系统的管理,我们通过免疫层析法(ICA)评估了抗tTG的出现情况。
总共103例CD患者和41例疾病对照者接受了十二指肠活检用于器官培养。在培养上清液中,通过酶联免疫吸附测定(ELISA)和ICA检测IgA抗tTG,通过间接免疫荧光分析(iIFA)检测IgA EMA。
通过ELISA检测的肌内膜抗体和抗tTG在所有CD患者的培养基中均为阳性,而通过ICA检测的抗tTG在103例CD患者中的87例培养基中为阳性。抗tTG ICA评分与抗tTG ELISA值显著相关(r = 0.71,P < 0.0001)。通过ICA检测的抗tTG的敏感性、特异性和诊断准确性分别为84.5%、100%和88.9%。
使用ICA,在大多数CD患者的十二指肠培养基中可检测到抗tTG,指示线的强度取决于抗tTG浓度。ICA的敏感性和诊断准确性低于ELISA,但鉴于前者是一种更简便快捷的方法,数据表明其有可能用于CD的体外诊断。