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New Serology Assays Can Detect Gluten Sensitivity among Enteropathy Patients Seronegative for Anti-Tissue Transglutaminase

Sugai, E., Hwang, H. J., Vazquez, H., Smecuol, E., Niveloni, S., Mazure, R., Maurino, E., Aeschlimann, Pascale Corinne, Binder, W., Aeschlimann, Daniel ORCID: https://orcid.org/0000-0003-0930-7706 and Bai, J. C. 2010. New Serology Assays Can Detect Gluten Sensitivity among Enteropathy Patients Seronegative for Anti-Tissue Transglutaminase. Clinical Chemistry 56 (4) , pp. 661-665. 10.1373/clinchem.2009.129668

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Abstract

BACKGROUND: Some patients with celiac disease ( CD) may be seronegative with the commonly used test for IgA anti-tissue transglutaminase (anti-tTG) antibodies. Our aim was to explore whether newer assays incorporating synthetic deamidated gliadin-related peptides (DGPs) or other TG isoenzymes as antigen are useful for detecting gluten sensitivity in IgA anti-tTG seronegative patients. METHODS: We assayed serum samples obtained at diagnosis from (a) anti-tTG-seronegative patients with a CD-like enteropathy (n = 12), (b) skin biopsy-proven dermatitis herpetiformis (DH) patients (n = 26), and (c) IgA anti-tTG-positive CD patients (n = 26). All patients had typical total IgA concentrations. All patients underwent intestinal biopsy and serum testing for (a) detection of IgA and IgG isotypes of both anti-DGP and anti-tTG in a single assay (tTG/DGP Screen; INOVA Diagnostics), (b) simultaneous detection of both IgA and IgG anti-DGP antibody isotypes (DGP Dual; INOVA Diagnostics), and (c) detection of antibodies to transglutaminase 3 (TG3) or transglutaminase 6 (TG6). RESULTS: All anti-tTG-seropositive patients also tested positive in anti-DGP assays. Overall, tTG/DGP Screen detected 6 (31.6%) of the 19 anti-tTG seronegatives, and anti-DGP Dual produced positive results in 5 (26.3%) of these cases. Whereas both assays detected 2 anti-tTG-negative DH patients with partial villous atrophy, they were positive in only 2 of the 5 cases with no histologically discernible mucosal damage. Testing for antibodies to TG3 and TG6 identified 7 (36.8%) of the 19 anti-tTG-negative patients, 5 of which were also positive for anti-DGP. CONCLUSIONS: Detection of anti-DGP with tTG/DGP Screen or anti-DGP Dual, or detection of antibodies to other TG isoenzymes, enhances the sensitivity for detecting gluten sensitivity among non-IgA-deficient, anti-tTG-seronegative patients with CD-like enteropathy.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Dentistry
Publisher: American Association for Clinical Chemistry
ISSN: 0009-9147
Last Modified: 18 Oct 2022 13:59
URI: https://orca.cardiff.ac.uk/id/eprint/16086

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