Sulkanen S, Collin P, Laurila K, Mäki M
Institute of Medical Technology and Medical School, University of Tampere, Finland.
Scand J Gastroenterol. 1998 Mar;33(3):251-4. doi: 10.1080/00365529850170810.
An antiendomysium antibody test using human umbilical cord as antigen has recently been introduced.
We determined IgA- and IgG-class antihuman umbilical cord (HUC-ab), antireticulin (ARA), and antigliadin antibodies (AGA) in 92 untreated adult coeliac patients, in 95 non-coeliac subjects, and in 4 coeliac patients with selective IgA deficiency. Tissue antibodies were measured with an indirect immunofluorescence method and AGA with an enzyme-linked immunosorbent assay.
Of adult coeliac patients 85% were positive for IgA-class HUC-ab, 78% were positive for ARA, and 80% for AGA; the specificity for HUC-ab and ARA was 100%, and for AGA 86%. Combination of HUC-ab, ARA, and high-titre AGA increased the sensitivity to 96% without loss of specificity. IgG-class HUC-ab was positive in 12% of coeliac patients, in all four coeliac patients with IgA deficiency, and in none of the controls.
The HUC-ab test is highly specific but not 100% sensitive for detecting adult coeliac disease. A combination of the IgA-class HUC-ab, ARA, and high-titre AGA tests is recommended. In selective IgA deficiency the IgG-class HUC-ab test seems to work well.
最近引入了一种以人脐带为抗原的抗肌内膜抗体检测方法。
我们测定了92例未经治疗的成年乳糜泻患者、95例非乳糜泻受试者和4例选择性IgA缺乏的乳糜泻患者的IgA和IgG类抗人脐带（HUC-ab）、抗网硬蛋白（ARA）和抗麦醇溶蛋白抗体（AGA）。采用间接免疫荧光法检测组织抗体，采用酶联免疫吸附测定法检测AGA。
成年乳糜泻患者中，85%的患者IgA类HUC-ab呈阳性，78%的患者ARA呈阳性，80%的患者AGA呈阳性；HUC-ab和ARA的特异性为100%，AGA的特异性为86%。HUC-ab、ARA和高滴度AGA联合检测可将敏感性提高至96%，且不损失特异性。12%的乳糜泻患者IgG类HUC-ab呈阳性，所有4例选择性IgA缺乏的乳糜泻患者均呈阳性，而对照组均为阴性。
HUC-ab检测对检测成年乳糜泻具有高度特异性，但并非100%敏感。建议联合检测IgA类HUC-ab、ARA和高滴度AGA。在选择性IgA缺乏的情况下，IgG类HUC-ab检测似乎效果良好。
