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The antigen for immunoglobulin (Ig) A endomysium antibody (EmA), a sensitive and specific serological marker for celiac disease, has recently been described as tissue transglutaminase (tTG). The aim of this study was to compare the assays used to measure IgA EmA and IgA tTG antibody in patients with celiac disease and disease control subjects. Sera...
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Context 1
... samples from patients with treated celiac disease were negative for IgA EmA, and 15 were positive. IgA antibody to tTG: The titres of IgA tTG antibody are shown in Figure 1 and Table 2. The titres were significantly higher in the untreated celiac group than in the EmA- negative groups (P<0.0001) and the EmA-positive, treated group (P=0.027). ...
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Both celiac disease and scleroderma have autoimmune etiology and affect the bowel causing diarrhea. As an association of autoimmune disease in a single individual is not rare, it is important to know if a patient with scleroderma may also have celiac disease. To analyze this we studied 105 scleroderma patients and 97 volunteers for IgA-EmA by indir...
Citations
... In the current work, the no significant differences of IgA-TTG was consistent with formerly described findings [32]. However these outcomes were steady with those little studies that conveyed less sensitivity of mentioned test clinically [33,34]. ...
For finding or inquiring the efficiency of measuring the concentrations of IgG and IgA anti-gliadin autoantibodies (IgG and IgA AGA, respectively), IgA and IgG anti-transglutaminase (TGA), for gluten sensitivity diagnosis and study the relationship between those antibodies with age and gender of patients. The number of coeliac patients that enrolled in current study was 169. Concentrations of IgA, IgG for AGA as well as IgG, IgA for TgA was measured via enzyme-linked immunosorbent assay (ELISA). In the present study, the mean±SE of IgA antigliadin and IgA antitransglutaminase in age group 1-9 years was higher than 10-19 years without significance differences between them p>0.05, while the result show significant differences p<0.05 among age study groups in respect to IgG antiglidin and IgG transglutaminase since the mean of concentration in smaller ages was higher than older (10-19) years. In respect to gender, the females IgA antigliadin and tissue transglutaminase concentrations was higher than their concentrations in males with no significance differences detected between studied groups, while in other autoantibody tested, IgG antigladin and antitrasglutaminase concentrations there is significance differences between females and males with higher mean in females than males. According to the present study results, there are significant correlation between IgG antigliadin and anti-tissue transglutaminase with age and gender of celiac disease patients, since there concentration was higher in females younger than 10 years.
... In the current work, the no significant differences of IgA-TTG was consistent with formerly described findings [32]. However these outcomes were steady with those little studies that conveyed less sensitivity of mentioned test clinically [33,34]. ...
the aim of study is to find the correlation between auto-antibodies concentration used for routinely celiac disease diagnosis with age and gender of sample study patients
... Many studies have demonstrated that these assays have exhibited excellent diagnostic performance, reaching a sensitivity and specificity that is comparable of IgA-EMA (Gillett and Freeman, 2000, Chan et al., 2001, Poddar et al., 2008, Barakauskas et al., 2014, Di Sabatino et al., 2017. Nevertheless, other work has found that specificity of IgA-EMA assays was superior to that of IgA-tTG, predominantly in instances when the control group involved patients with autoimmune diseases, such as autoimmune liver disease and type I diabetes mellitus (Carroccio et al., 2001, Clemente et al., 2002, Weiss et al., 2004, Admou et al., 2012. ...
... Чувствительность и специфичность АГА IgG находится в пределах от 69 до 89% и от 71 до 82% соответственно. Из-за невысокой специфичности и чувствительности определение АГА постепенно теряет диагностическую значимость и чаще применяется для контроля за тщательностью соблюдения аглютеновой диеты (АГД) [4,5]. ...
Aim:
To determine celiac disease detection rate in patients with digestive disease.
Subjects and methods:
A total of 318 gastroenterological patients admitted to be treated at the Central Research Institute of Gastroenterology in September to October 2012 were examined. The patients' age was 18 to 74 years (mean 51.5±16.4 years). Immunoglobulin A (IgA) and immunoglobulin G (IgG) anti-gliadin antibodies (AGA), IgA anti-tissue transglutaminase (anti-tTG) antibodies and IgG anti-tTG antibodies were determined. When the antibodies were elevated, esophagogastroduodenoscopy with duodenal biopsy was performed.
Results:
Forty-one of the 318 patients were found to have higher AGA (12.9%); out of them IgA AGA were in 17 (5.35%) patients and IgG AGA were also in 17 (5.35%). Elevated levels of both antibodies (IgA AGA and IgG AGA) were seen in 7 (2.2%) patients. Overall, the detection rate of increased AGA levels was 12.9%. The antibodies were more commonly higher in patients with liver diseases (21.8%) and in those with inflammatory bowel diseases (21.6%). Both IgA anti-tTG, IgG anti-tTG and IgA AGA, IgG AGA were detected in 6 (1.9%) of the 318 patients. The diagnosis of celiac disease was verified by duodenal histological examination in 3 (0.94%) of the 318 patients.
Conclusion:
The celiac disease detection rate in gastroenterological patients was 0.94%.
... Despite the advent of newer tests, IgA anti-tTG ELISA is the standard test of choice in most communities.[22] The diagnostic kit of tTG with guinea pig antigen has high false positive, but in this study kit of recombinant human tTG antigen with higher specificity was used.[23–25] This subject elevates the quality of this study and it seems necessary to review the results of previous studies. ...
The prevalence of irritable bowel syndrome (IBS) in the community is 10%-20% and have symptom based diagnostic criteria. Many symptoms of celiac disease (CD) with 1% prevalence in some communities can mimic IBS. Sensitive and specific serologic tests of CD can detect asymptomatic cases. The purpose of this study was to compare the level of anti-tissue-transglutaminase (tTG) IgA in IBS patients and controls group.
This case-control study was performed at a University hospital in which 107 patients with IBS who met the Rome II criteria for their diagnosis were compared with 126 healthy age and sex-matched controls. Both groups were investigated for CD by analysis of their serum tTG IgA antibody with human recombinant antigen. Titers were positive containing over 10u/ml and borderline if they were between 4 and 10 u/ml.
86 percent of IBS patients were female. The mean antibody level was 0.837 u/ml in IBS group and 0.933 u/ml in control group without any significant difference.
Results of this study may intensify disagreement on the situation of CD in IBS patients.
... In adults with celiac disease, weakness and fatigue could also result from changes in nerves (e.g. peripheral nerve lesion) [12] , or alternatively, skeletal muscle (e.g. rhabdomyolysis, myositis) [13,14] . ...
Celiac disease has been associated with some autoimmune disorders. A 40-year-old competitive strongman with celiac disease responded to a gluten-free diet, but developed profound and generalized motor weakness with acetylcholine receptor antibody positive myasthenia gravis, a disorder reported to occur in about 1 in 5000. This possible relationship between myasthenia gravis and celiac disease was further explored in serological studies. Frozen stored serum samples from 23 acetylcholine receptor antibody positive myasthenia gravis patients with no intestinal symptoms were used to screen for celiac disease. Both endomysial and tissue transglutaminase antibodies were examined. One of 23 (or, about 4.3%) was positive for both IgA-endomysial and IgA tissue transglutaminase antibodies. Endoscopic studies subsequently showed duodenal mucosal scalloping and biopsies confirmed the histopathological changes of celiac disease. Celiac disease and myasthenia gravis may occur together more often than is currently appreciated. The presence of motor weakness in celiac disease may be a clue to occult myasthenia gravis, even in the absence of intestinal symptoms.
... Dieterich et al. (1997 have identified tTG as the auto-antigen with which EMA reacts. The subsequent development of an accurate and inexpensive ELISA for tTG, together with its high sensitivity and specificity, has led to a move towards using tTG as the serological test of choice for the diagnosis of CD (Bazzigaluppi et al. 1999;Biagi et al. 1999;Gillett & Freeman, 2000a;Fabiani et al. 2004;Reif & Lerner, 2004;PG Hill, JM Forsyth, D Semeraro and GKT Holmes, unpublished results). ...
Coeliac disease is a lifelong intolerance to the gluten found in wheat, barley and rye, and some patients are also sensitive to oats. The disease is genetically determined, with 10% of the first-degree relatives affected and 75% of monozygotic twins being concordant. Of the patients with coeliac disease 95% are human leucocyte antigen (HLA)-DQ2 or HLA-DQ8 positive. Characteristically, the jejunal mucosa becomes damaged by a T-cell-mediated autoimmune response that is thought to be initiated by a 33-mer peptide fragment in A2 gliadin, and patients with this disorder have raised levels of anti-endomysium and tissue transglutaminase antibodies in their blood. Coeliac disease is the major diagnosable food intolerance and, with the advent of a simple blood test for case finding, prevalence rates are thought to be approximately 1:100. Classically, the condition presented with malabsorption and failure to thrive in infancy, but this picture has now been overtaken by the much more common presentation in adults, usually with non-specific symptoms such as tiredness and anaemia, disturbance in bowel habit or following low-impact bone fractures. Small intestinal biopsy is necessary for diagnosis and shows a characteristically flat appearance with crypt hypoplasia and infiltration of the epithelium with lymphocytes. Diet is the key to management and a gluten-free diet effectively cures the condition. However, this commitment is lifelong and many aisles in the supermarket are effectively closed to individuals with coeliac disease. Compliance can be monitored by measuring antibodies in blood, which revert to negative after 6-9 months. Patients with minor symptoms, who are found incidentally to have coeliac disease, often ask whether it is necessary to adhere to the diet. Current advice is that dietary adherence is necessary to avoid the long-term complications, which are, principally, osteoporosis and small bowel lymphoma. However, risk of these complications diminishes very considerably in patients who are on a gluten-free diet.
... Dieterich et al (1) identified tissue transglutaminase (tTG), an enzyme normally involved in wound repair, as the endomysial 'auto-antigen' of celiac disease, and suggested its use to screen for celiac disease. Indeed, this has been widely applied (2)(3)(4), and the utility of an antibody assay in screening populations (eg, childhood insulin-dependent diabetes) for biopsy-defined celiac disease has been demonstrated in our own studies (5,6). ...
... Indeed, in our own prior studies, the absolute tTG antibody levels varied by as much as 1000-fold in untreated celiac disease (4). Correlation between tTG antibody level and degree of severity of mucosal injury has also been reported based on untreated and treated celiac disease biopsies (4). Higher mean levels of tTG were seen with most severe biopsy changes; however, the correlation between individual assay results and degree of histological abnormality was limited with overlap even with normal biopsies. ...
Celiac disease is a small bowel disorder characterized by flattened villi and crypt hyperplasia, often with malabsorption. Improvement occurs with a gluten-free diet. Sensitive and specific assays (eg, immunoglobulin A antibodies to tissue transglutaminase [tTG]) that can be quantified appear to be valuable tools for population screening studies. In addition, their use is expanding widely in the clinical practice arena, being employed as a method of case finding. In this evaluation, clinical use of a commercially available test kit was explored. Of 1330 samples submitted to our hospital laboratory by physicians in British Columbia, Alberta and the Yukon Territory (from 1999 to 2003, inclusive), 96 patients (7%) had increased values (normal range greater than 20 units) and markedly increased levels greater than 100 units were detected in 36 patients (3%). Of these, 14 patients (almost 40%) were referred to gastroenterologists in our hospital and all 14 had small intestinal biopsies. Of these, three patients (more than 20%) did not have celiac disease. Two had normal small bowel biopsies and one had unclassified sprue or 'sprue-like' intestinal disease that failed to respond to a gluten-free diet. The other 11 had biopsy-defined celiac disease. While the tTG assay may be a useful predictor of celiac disease, small intestinal biopsy is still required to confirm the diagnosis. In clinical practice, even strongly positive tTG results are not specific in individual patients, do not necessarily correlate with the degree of severity of biopsy change and, as a result, are also unlikely to be useful for monitoring diet compliance.
... In addition, results of special stains for Helicobacter pylori, done in each patient, were recorded. After serum assays for tissue transglutaminase antibodies were developed for research purposes in the University of British Columbia Hospital laboratory (24), separate clinical assays were developed in the hospital. For the patients in the present study, all four that were tested had positive tissue transglutaminase antibody results using this clinical assay, but only after initial biopsy results were known, and before the institution of a gluten-free diet. ...
Celiac disease is thought to be a genetically based disorder reported mainly from European countries as well as countries to which Europeans have emigrated, including North America. This report documents a clinical experience of biopsy-defined celiac disease in 14 Asians diagnosed since 1988 in a single Canadian teaching hospital. Eleven were Indo-Canadians, including 10 of Punjabi descent. Other ethnic groups were also represented, including two Japanese and one Chinese patient. Abdominal pain was the most frequent presenting symptom. Anemia, particularly associated with a deficiency of iron was common, along with diarrhea and weight loss. Endoscopic studies documented lymphocytic gastric and colonic mucosal changes in over one-third of the cases while antibodies for tissue transglutaminase were positive in all patients tested. Dermatitis herpetiformis, diabetes mellitus and autoimmune liver disease were also documented. These findings indicate for the first time that adult celiac disease occurs in Asian populations living in North America, particularly in those of Punjabi descent.
... An ELISA to measure IgA tTG against guinea pig tTG was established using the method of Dieterich et al (13) and validated in 21 untreated adults with CD, 48 treated adult celiacs and 128 disease controls (14). A reference range of 140 arbitrary units (AU)/mL or less was calculated to include three standard deviations above the mean (99% confidence limits). ...
... The fourth patient (patient 12, Table 1) frequently lapsed from his diet and had a tTG titre in excess of 28,000 AU/mL. Titres of tTG are generally lower in treated than in untreated patients (13,14,21). These studies suggest that tTG serology may also be useful in monitoring response and compliance to a GFD. ...
To establish the prevalence of celiac disease (CD) in children with type 1 diabetes in British Columbia.
Two hundred thirty-three children with type 1 diabetes were prospectively screened for CD using blind testing with the current 'gold standard', immunoglobulin A endomysium antibody (EmA), and the novel immunoglobulin A tissue transglutaminase (tTG) antibody. Those children with positive results were offered small bowel biopsy; a gluten-free diet was recommended if CD was confirmed.
Nineteen children were positive for EmA and had an elevated tTG level. One patient from this group was already known to have CD, and the other 18 patients consented to biopsy. One biopsy was normal, three biopsies demonstrated elevated intraepithelial lymphocyte counts with normal morphology and 14 biopsies had morphological changes consistent with CD. Growth parameters were normal in all patients, and nine of 19 children who were positive for EmA were asymptomatic. Seven patients had mild elevation of tTG levels alone. Two children from this latter group had normal biopsies, and five declined biopsy.
At least 14 new cases of CD were detected in addition to four known cases, yielding an overall biopsy-confirmed prevalence of CD of 7.7% (18 of 233). The present study confirms that CD is as prevalent in the pediatric type 1 diabetic population in British Columbia as it is in Europe. Serological screening of these children is important because many children have no symptoms or signs suggestive of CD. This study suggests that tTG serology may also be useful in monitoring response and compliance with a gluten-free diet.
