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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