Rotolo N, Bottaro G, Spina M, Azzaro F, Pasqualetto A, Castiglione N, Randazzo C, Patané R
I Clinica Pediatrica, Università degli Studi di Catania.
Minerva Pediatr. 1993 Sep;45(9):357-61.
Since their introduction in clinical practice, antigliadin antibodies (AGA) have simplified the diagnostic iter of coeliac disease. In addition they have allowed us to recognize an even high number of new cases and also to identify new clinical forms. While AGA are widely used in the diagnostic phase, their determination during follow-up of the disease has been always limited. With the present work we observe the behaviour of AGA during the various phases of coeliac disease. The study was carried out on 288 coeliac children divided as follows: 96 at diagnosis, 136 on gluten-free-diet (75 diet adherent and 61 non adherent) and 56 on gluten-challenge. 145 healthy children were also studied as a control group. In all children AGA (IgA and IgG) were determined, with a micro-ELISA method, every two months in the children on gluten-free-diet and monthly in the children on gluten-challenge. Data obtained showed AGA behaviour strictly related to the diet. In fact while children with good compliance to the diet had AGA normalization within the 2nd and 6th month, respectively for IgA and IgG, children with poor adherence to diet had constantly positive AGA. Noteworthy was the AGA behaviour during challenge. Gluten introduction determined a rapid increase of IgA and a slow increase of IgG. Our results confirm the usefulness of AGA determination during the follow-up of coeliac children giving us the possibility to avoid one or more biopsies included in the ESPGAN protocol.
自从抗麦醇溶蛋白抗体（AGA）被引入临床实践以来，它简化了乳糜泻的诊断流程。此外，它使我们能够识别出更多新病例，并发现新的临床类型。虽然AGA在诊断阶段被广泛应用，但其在疾病随访期间的检测一直受到限制。通过本研究，我们观察了AGA在乳糜泻各个阶段的表现。该研究对288名乳糜泻儿童进行，分组如下：96名处于诊断阶段，136名采用无麸质饮食（75名饮食依从性好，61名依从性差），56名进行麸质激发试验。还对145名健康儿童作为对照组进行了研究。对所有儿童，采用微酶联免疫吸附测定法，对采用无麸质饮食的儿童每两个月检测一次AGA（IgA和IgG），对进行麸质激发试验的儿童每月检测一次。所获数据显示AGA的表现与饮食密切相关。事实上，饮食依从性好的儿童，其IgA和IgG的AGA分别在第2个月和第6个月恢复正常，而饮食依从性差的儿童，其AGA持续呈阳性。值得注意的是麸质激发试验期间AGA的表现。引入麸质后，IgA迅速升高，IgG缓慢升高。我们的结果证实了在乳糜泻儿童随访期间检测AGA的有用性，使我们有可能避免欧洲儿科胃肠病、肝病和营养学会（ESPGAN）方案中包含的一次或多次活检。
