Romaldini C C, Barbieri D
Unidade de Gastroenterologia, Instituto da Criança Prof. Pedro de Alcantara, Faculdade de Medicina da Universidade de São Paulo.
Arq Gastroenterol. 1997 Oct-Dec;34(4):254-61.
Serum antigliadin IfA class antibodies (AAG-IgA) were measured by ELISA assay in 65 children into three groups. Group I consisted of 20 control children; Group II of 31 celiac patients on different treatment periods (P1, on a normal diet; P2, after sixth month on gluten-free diet; P3, one three years of treatment and P4, three years and one month to nine years of treatment) and Group III of 14 food hypersensitivity patients. IgA-deficiency was ruled out in all patients. Positivity was considered for titers > 30.3 UA obtained from controls. The AAG-IgA titer was positive in 9 of 10 celiac patients on P1. Nine of these 10 patients were tested on P2; all cases showed a decrease in the AAG-IGA level and a significant difference was observed between the mean values for P1 and P2; although seven patients had maintained positive titers. On P3 and P4 all patients had AAG-IGa negative levels. On P1 the AAG-IGA liter levels were significantly higher than the values for P2, P3 and P4. The AAG-IgA values decreased towards control levels after one year of treatment. In Group III one out of 14 patients had a positive titer and the AAG-IgA values in this group were significantly lower than the celiac titers on P1 and P2 and no difference was found compared to patients titers on P3 and P4. The sensitivity of ELISA test was 90% and the specificity 93%. The AAG-IgA determination proved to be reliable for differentiating celiac disease from food hypersensitivity and useful in monitoring gluten-free diet compliance.
采用酶联免疫吸附测定法（ELISA）检测了65名儿童血清中的抗麦醇溶蛋白IgA类抗体（AAG-IgA），并将这些儿童分为三组。第一组由20名对照儿童组成；第二组为31名处于不同治疗阶段的乳糜泻患者（P1阶段，正常饮食；P2阶段，无麸质饮食6个月后；P3阶段，治疗1至3年；P4阶段，治疗3年零1个月至9年）；第三组为14名食物过敏患者。所有患者均排除了IgA缺乏症。以对照组获得的滴度>30.3 UA为阳性标准。P1阶段的10名乳糜泻患者中有9名AAG-IgA滴度呈阳性。这10名患者中的9名在P2阶段接受了检测；所有病例的AAG-IGA水平均下降，且P1和P2阶段的平均值之间存在显著差异；尽管有7名患者的滴度仍为阳性。在P3和P4阶段，所有患者的AAG-IGa水平均为阴性。在P1阶段，AAG-IGA滴度水平显著高于P2、P3和P4阶段的值。治疗一年后，AAG-IgA值降至对照水平。在第三组中，14名患者中有1名滴度呈阳性，该组的AAG-IgA值显著低于P1和P2阶段的乳糜泻患者滴度，与P3和P4阶段患者的滴度相比无差异。ELISA检测的灵敏度为90%，特异性为93%。结果证明，AAG-IgA测定对于区分乳糜泻和食物过敏是可靠的，并且有助于监测无麸质饮食的依从性。
