Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase

Ingrid Dahlbom, Ilma R. Korponay-Szabó, J. Kovács, Z. Szalai, Markku Mäki, Tony Hansson

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Objectives: We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity. Patients and Methods: One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies. Results: Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P <0.001). The IgG-TGA levels and positivity rate in group I (100%) were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P <0.0001) with a specificity of 99% for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II. Conclusions: High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.

Original languageEnglish
Pages (from-to)140-146
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume50
Issue number2
DOIs
Publication statusPublished - Feb 2010

Fingerprint

Dermatitis Herpetiformis
Celiac Disease
Immunoglobulin A
Immunoglobulin G
Antibodies
Serum
Atrophy
transglutaminase 2
Gluten-Free Diet
Glutens
Wetlands
Autoantibodies
Enzyme-Linked Immunosorbent Assay
Diet
Biopsy

Keywords

  • Coeliac disease
  • Dermatitis herpetiformis
  • IgA autoantibodies
  • IgG autoantibodies
  • Tissue transglutaminase
  • Transglutaminase type 2

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase. / Dahlbom, Ingrid; Korponay-Szabó, Ilma R.; Kovács, J.; Szalai, Z.; Mäki, Markku; Hansson, Tony.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 50, No. 2, 02.2010, p. 140-146.

Research output: Contribution to journalArticle

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abstract = "Objectives: We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity. Patients and Methods: One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies. Results: Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95{\%} of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P <0.001). The IgG-TGA levels and positivity rate in group I (100{\%}) were higher than in group II (81{\%}), group III (73{\%}), and the DH group (67{\%}). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P <0.0001) with a specificity of 99{\%} for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II. Conclusions: High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.",
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T1 - Prediction of clinical and mucosal severity of coeliac disease and dermatitis herpetiformis by quantification of IgA/IgG serum antibodies to tissue transglutaminase

AU - Dahlbom, Ingrid

AU - Korponay-Szabó, Ilma R.

AU - Kovács, J.

AU - Szalai, Z.

AU - Mäki, Markku

AU - Hansson, Tony

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AB - Objectives: We analysed whether the quantification of autoantibodies against tissue transglutaminase could be used to predict mucosal destruction and disease severity in patients with gluten sensitivity. Patients and Methods: One hundred seventy patients with coeliac disease (CD), comprising 52 children with severe malabsorption (group I), 59 children with mild symptoms (group II), 59 adults (group III), 134 patients with dermatitis herpetiformis (DH), and 131 disease controls, were studied. Serial serum samples of patients in groups I and II on a gluten-free diet were also included. Serum levels of antibodies against recombinant tissue transglutaminase were determined with ELISA using standard curves for quantification of antibodies. Results: Immunoglobulin (Ig)A antibodies against tissue transglutaminase (IgA-TGA) were detected in all of the patients with CD and in 95% of the DH patients. The IgA-TGA and IgG-TGA levels were higher in group I (P <0.001). The IgG-TGA levels and positivity rate in group I (100%) were higher than in group II (81%), group III (73%), and the DH group (67%). Elevated IgA-TGA and IgG-TGA levels in combination predicted a more severe small intestinal atrophy (P <0.0001) with a specificity of 99% for Marsh IIIb-IIIc (flat) lesions. The kinetics of the IgA-TGA decrease during diet differed between groups I and II. Conclusions: High levels of IgA-TGA and IgG-TGA antibodies were associated with the grade of mucosal villous atrophy and a more severe clinical presentation. The combined measurement of IgA-TGA and IgG-TGA enables a noninvasive prediction of small intestinal villous atrophy with high accuracy, and may reduce the need for a biopsy in patients with suspected CD.

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KW - Dermatitis herpetiformis

KW - IgA autoantibodies

KW - IgG autoantibodies

KW - Tissue transglutaminase

KW - Transglutaminase type 2

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