Alimentary TractTissue transglutaminase autoantibody enzyme-linked immunosorbent assay in detecting celiac disease☆,☆☆
Section snippets
Patients
The patients had been examined at the Departments of Pediatrics or Medicine at Tampere University Hospital and at the Children's Hospital, Helsinki University. Small bowel biopsy specimens were taken by using the Watson capsule technique or endoscopically.
Serum samples were obtained from 136 consecutive patients with untreated celiac disease (median age, 10.7 years; range 0.8–69.3) who had severe villous atrophy and crypt hyperplasia and who were on a normal diet (group I). In children, the
Tissue transglutaminase antibody ELISA test
The mean optical density for the first 20 patients with untreated celiac disease was 0.455 (95% confidence interval [CI], 0.237–0.673) and for the first 24 disease control patients 0.132 (95% CI, 0.124–0.140) tested with ELISA using tissue transglutaminase in PBS as antigen. Thus, the test seemed to distinguish celiac patients from controls. However, all sera tested had a high sample background. The optical densities without coating with tissue transglutaminase were 0.499 (95% CI, 0.209–0.789)
Discussion
In untreated celiac disease, ingested gluten triggers the production of IgA class serum tissue autoantibodies, i.e., R1-type reticulin, endomysial, and jejunal antibodies.2, 3, 17, 18, 19, 20, 21, 24 These antibodies seem to be highly specific for celiac disease, and they are directed against certain noncollagenous structures in the human extracellular matrix.25 However, the identity of the autoantigen has remained elusive. Recently, Dieterich et al.11 reported that tissue transglutaminase
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Address requests for reprints to: Markku Mäki, M.D., Celiac Disease Study Group, Institute of Medical Technology, University of Tampere, P.O. Box 607, FIN-33101 Tampere, Finland. e-mail: [email protected]; fax: (358) 3-215-7746; Web site: http://www.uta.fi/~llmama/
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Supported by the Foundation for Pediatric Research, Medical Research Fund of Tampere University Hospital, Medical Research Council, Academy of Finland, and Sigrid Juselius Foundation.