Dieterich W, Laag E, Schöpper H, Volta U, Ferguson A, Gillett H, Riecken E O, Schuppan D
Department of Gastroenterology, Klinikum Benjamin Franklin, Free University of Berlin, Berlin, Germany.
Gastroenterology. 1998 Dec;115(6):1317-21. doi: 10.1016/s0016-5085(98)70007-1.
BACKGROUND & AIMS: Immunoglobulin A (IgA) autoantibodies to endomysium (EMA) are highly specific and sensitive markers for celiac disease. Recently, we identified tissue transglutaminase (tTG) as the major if not sole endomysial autoantigen.
An enzyme-linked immunosorbent assay (ELISA) was established to measure IgA anti-tTG titers in serum samples from 106 celiac patients with partial or subtotal villous atrophy, 43 celiac patients on a gluten-free diet, and 114 diseased and healthy controls. Results were correlated with clinical and histological data and with EMA titers.
In patients with biopsy-proven celiac disease consuming a normal, gluten-containing diet, 98.1% of the serum samples had elevated IgA titers against tTG, whereas 94.7% of the control sera were negative. IgA anti-tTG correlated positively with semiquantitative IgA EMA titers (r = 0.862; P < 0.0001).
An ELISA based on tTG allows diagnosis of celiac disease with a high sensitivity and specificity. IgA anti-tTG and IgA EMA show an excellent correlation, further confirming the enzyme as the celiac disease autoantigen. Because the assay is quantitative, not subjected to interobserver variation, and easy to perform, it will be a useful tool for population screening of a hitherto underdiagnosed disease.
抗肌内膜免疫球蛋白A（IgA）自身抗体是乳糜泻高度特异且敏感的标志物。最近，我们确定组织转谷氨酰胺酶（tTG）为主要的（即便不是唯一的）肌内膜自身抗原。
建立酶联免疫吸附测定（ELISA）法，以检测106例有部分或全部绒毛萎缩的乳糜泻患者、43例接受无麸质饮食的乳糜泻患者以及114例患病和健康对照者血清样本中的IgA抗tTG滴度。结果与临床和组织学数据以及EMA滴度相关。
在经活检证实患有乳糜泻且食用含麸质正常饮食的患者中，98.1%的血清样本IgA抗tTG滴度升高，而94.7%的对照血清为阴性。IgA抗tTG与半定量IgA EMA滴度呈正相关（r = 0.862；P < 0.0001）。
基于tTG的ELISA法可高灵敏度和特异性地诊断乳糜泻。IgA抗tTG和IgA EMA显示出极佳的相关性，进一步证实该酶为乳糜泻自身抗原。由于该检测是定量的，不受观察者间差异影响且易于操作，它将成为对一种迄今诊断不足的疾病进行人群筛查的有用工具。
