Significance of a method for determination of deamidated gliadin peptide in the diagnosis of celiac disease

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Abstract

AIM: To define the value of a new enzyme immunoassay in determining the level of anti-deamidated gliadin peptide (DGP) antibodies (Abs) in the diagnosis of celiac disease/MATERIAL AND METHODS: One hundred and twenty-four patients treated at the Department of Intestinal Pathology, Central Research Institute of Gastroenterology, were examined. Enzyme-linked immunosorbent assay (ELISA) was employed to determine Abs to tissue transglutaminase (tTG) and DGP of the IgA and IgG classes in the sera of all the patients. The diagnosis of celiac disease was verified by the histological examination of small bowel mucosa biopsy specimens/RESULTS: The examinees were divided into 3 groups: 1) 27 patients first diagnosed with celiac disease; 2) 40 patients keeping a gluten-free diet (GFD); 3) 57 patients with other gastrointestinal diseases (a comparison group). In the patients first diagnosed with celiac disease, the detection rate of elevated titers of anti-tTG and anti-DGP Abs in the IgA class was equal and constituted 92.5%; that in the IgG class was 96.2 and 55.5%, respectively. The comparison group showed an increase in the DGP levels in the IgA and IgG classes in 4 (7%) patients and a rise in tTG concentrations in the IgA and IgG classes was seen in only 2 (3.5%) patients/CONCLUSION: In the patents first diagnosed with celiac disease, the detection rate of elevated levels of anti-DGP Abs in the IgA and IgG classes is 92.5 and 96.2%, respectively, and significantly indifferent from that of IgA and IgG anti-tTG Abs. The patients keeping GFD displayed a reduction in anti-DGP Abs. The high detection rate of IgA anti-DGP Abs in the patients first diagnosed with celiac disease allows this method to be recommended for immunological diagnosis of this disease in adults.

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Значение метода определения деамидированного пептида глиадина в диагностике целиакии. - Резюме. Цель исследования. Определить значение нового иммунологического метода определения уровня антител (АТ) к деамидированному пептиду глиадина (DGP) в диагностике целиакии. Материалы и методы. Обследовали 124 больных, находившихся на лечении в отделении патологии кишечника ЦНИИГ. В сыворотке крови у всех больных иммуноферментным методом (ELISA) определяли АТ к тканевой трансглютаминазе tTG и DGP классов IgA и IgG. Диагноз целиакии подтверждали с помощью гистологического исследования слизистой оболочки тонкой кишки. Результаты. Обследованные больные были разделены на 3 группы: 1-я - 27 больных с впервые установленным диагнозом целиакии, 2-я - 40 больных, соблюдающих аглютеновую диету (АГД), 3-я (сравнения) - 57 больных с другими заболеваниями желудочно-кишечного тракта. У больных с впервые диагностированной целиакией частота выявления повышенных титров АТ к tTG и DGP класса IgA была одинаковой и составила 92,5%, класса IgG - 96,2 и 55,5% соответственно. В группе сравнения повышение DGP классов IgA и IgG выявлено у 4 (7%) больных, а повышение уровня tTG IgA и IgG - лишь у 2 (3,5%). Заключение. Частота обнаружения повышенного уровня АТ к DGP IgA и IgG у больных с впервые выявленной целиакией составляет 92,5 и 96,2% соответственно, и достоверно не отличается от частоты повышения АТ к tTG IgA и IgG. У больных, соблюдающих АГД, наблюдается снижение АТ к DGP. Высокая частота выявления АТ к DGP IgA у больных с впервые диагностированной целиакией позволяет рекомендовать данный метод для иммунологической диагностики этого заболевания у взрослых.
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References

  1. Парфенов А.И. Целиакия. Эволюция представлений о распространенности, клинических проявлениях и значимости этиотропной терапии. М: Анахарсис 2007; 372.
  2. Mustalahti K., Catassi C., Reunanen A. et al. The prevalence of celiac disease in Europe: results of a centralized, international mass screening project. Ann Med 2010; 42 (8): 587-595.
  3. Jennifer M.B., Liu E. Celiac Disease: Pathophysiology, Clinical Manifestations and Associated Autoimmune Conditions. Adv Pediatr 2008; 55: 349-365.
  4. Hill I.D., Dirks M.H., Liptak G.S. et al. Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005; 40: 1-19.
  5. Osman A.A., Gunnel T., Dietl A. et al. B cell epitopes of gliadin. Clin Exp Immunol 2000; 121: 248-254.
  6. Aleanzi M., Demonte A.M., Esper C. et al. Celiac disease: antibody recognition against native and selectively deamidated gliadin peptides. Clin Chem 2001; 47: 2023-2028.
  7. Schwertz E., Kahlenberg F., Sack U. et al. Serologic assay based on gliadin-related nonapeptides as a highly sensitive and specific diagnostic aid in celiac disease. Clin Chem 2004; 50: 2370-2375.
  8. Panetta F., Torre G., Colistro F. et al. Clinical accuracy of anti-tissue transglutaminase as screening test for celiac disease under 2 years. Acta Paediatr 2011; 100 (5): 728-731.
  9. Prince H.E. Evaluation of the INOVA diagnostics enzyme-linked immunosorbent assay kits for measuring serum immunoglobulin G (IgG) and IgA to deamidated gliadin peptides. Clin Vaccine Immunol 2006; 13 (1): 150-151.
  10. Agardh D. Antibodies against synthetic deamidated gliadin peptides and tissue transglutaminase for the identification of childhood celiac disease. Clin Gastroenterol Hepatol 2007; 5 (11): 1276-1281.
  11. Ankelo M., Kleimola V., Simell S. Antibody responses to deamidated gliadin peptide show high specificity and parallel antibodies to tissue transglutaminase in developing coeliac disease. Clin Exp Immunol 2007; 150 (2): 285-293.
  12. Parizade M., Bujanover Y., Weiss B. et al. Performance of Serology Assays for Diagnosing Celiac Disease in a Clinical Setting. Clin Vaccine Immunol 2009; 16 (11): 1576-1582.
  13. Parizade M., Shainberg B. Positive Deamidated Gliadin Peptide Antibodies and Negative Tissue Transglutaminase IgA Antibodies in a Pediatric Population: To Biopsy or Not To Biopsy. Clin Vaccine Immunol 2010; 17 (5): 884-886.
  14. Sugai E., Vázquez H., Nachman F. et al. Accuracy of testing for antibodies to synthetic gliadin-related peptides in celiac disease. Clin Gastroenterol Hepatol 2006; 4 (9): 1112-1117.
  15. Rashtak S., Ettore M.W., Homburger H.A., Murray J.A. Comparative usefulness of deamidated gliadin antibodies in the diagnosis of celiac disease. Clin Gastroenterol Hepatol 2008; 6 (4): 426-432.
  16. Marietta E.V., Rashtak S., Murray J.A. Correlation analysis of celiac sprue tissue transglutaminase and deamidated gliadin IgG/IgA. World J Gastroenterol 2009; 15 (7): 845-848.
  17. Rozenberg O., Lerner A., Pacht A. et al. A new algorithm for the diagnosis of celiac disease. Cell Mol Immunol 2011; 8 (2): 146-149.
  18. Liu E., Li M., Emery L. et al. Natural history of antibodies to deamidated gliadin peptides and transglutaminase in early childhood celiac disease. J Pediatr Gastroenterol Nutr 2007; 45: 293-300.
  19. Volta U., Granito A., Fiorini E. et al. Usefulness of antibodies to deamidated gliadin peptides in celiac disease diagnosis and follow-up. Dig Dis Sci 2008; 53 (6): 1582-1528.
  20. Monzani A., Rapa A., Fonio P. et al. Use of deamidated gliadin peptide antibodies to monitor diet compliance in childhood celiac disease. J Pediatr Gastroenterol Nutr 2011; 53 (1): 55-60.

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Copyright (c) 2020 Sabel'nikova E.A., Parfenov A.I., Krums L.M., Gudkova R.B., Sagynbaeva V.É., Bykova S.V.

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