Tucker N T, Barghuthy F S, Prihoda T J, Kumar V, Lerner A, Lebenthal E
Department of Pediatrics, University of Texas Health Science Center, San Antonio 78284.
J Pediatr. 1988 Aug;113(2):286-9. doi: 10.1016/s0022-3476(88)80266-x.
Using an enzyme-linked immunosorbent assay (ELISA) assay, we studied the sera of 17 patients with celiac disease and 114 control subjects for the levels of IgG and IgA antigliadin antibodies. As a group, the patients with celiac disease had significantly higher levels of antigliadin antibodies of both IgG and IgA classes (p less than or equal to 0.001). However, there was a significant overlap of values, resulting in respective sensitivities and specificities of 88% and 90% for IgG antigliadin antibodies, and 73% and 65% for IgA antigliadin antibodies. The combined use of both IgG and IgA antigliadin antibody levels produced a sensitivity of 86% and a specificity of 90%. A gluten-free diet in celiac patients did not seem to affect these results. We conclude that the antigliadin antibody ELISA assay cannot be used as a definitive diagnostic test for celiac disease. The small-bowel biopsy remains the principal diagnostic method; the ELISA assay should, at best, be considered a screening test for this disease.
我们采用酶联免疫吸附测定（ELISA）法，研究了17例乳糜泻患者和114例对照者血清中IgG和IgA抗麦醇溶蛋白抗体的水平。总体而言，乳糜泻患者的IgG和IgA两类抗麦醇溶蛋白抗体水平均显著更高（p≤0.001）。然而，数值存在显著重叠，导致IgG抗麦醇溶蛋白抗体的敏感性和特异性分别为88%和90%，IgA抗麦醇溶蛋白抗体的敏感性和特异性分别为73%和65%。同时使用IgG和IgA抗麦醇溶蛋白抗体水平，敏感性为86%，特异性为90%。乳糜泻患者的无麸质饮食似乎并未影响这些结果。我们得出结论，抗麦醇溶蛋白抗体ELISA检测不能用作乳糜泻的确切诊断试验。小肠活检仍是主要的诊断方法；ELISA检测充其量应被视为该病的筛查试验。
