1. Antibodies to deamidated gliadin peptide in diagnosis of celiac disease in children.
- Author
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Lammi A, Arikoski P, Simell S, Kinnunen T, Simell V, Paavanen-Huhtala S, Hinkkanen A, Veijola R, Knip M, Toppari J, Vaarala O, Simell O, and Ilonen J
- Subjects
- Adolescent, Celiac Disease genetics, Child, Child, Preschool, Early Diagnosis, Female, Fluoroimmunoassay, GTP-Binding Proteins immunology, HLA-DQ alpha-Chains genetics, HLA-DQ beta-Chains genetics, Humans, Infant, Male, Protein Glutamine gamma Glutamyltransferase 2, ROC Curve, Retrospective Studies, Serologic Tests, Time Factors, Transglutaminases immunology, Celiac Disease blood, Celiac Disease diagnosis, Glutens immunology, Immunoglobulin A blood, Immunoglobulin G blood
- Abstract
Objectives: Determination of antibodies to synthetic deamidated gliadin peptides (anti-DGPs) may work as an alternative or complement the commonly used test for tissue transglutaminase antibodies (TGA) in the diagnosis of celiac disease (CD). We analyzed the performance of a time-resolved immunofluorometric anti-DGP assay (TR-IFMA) in the diagnosis of CD in children and also retrospectively analyzed the appearance of anti-DGP antibodies before TGA seroconversion., Methods: The study included 92 children with biopsy-confirmed CD. Serum samples were taken at the time or just before the clinical diagnosis. The control group comprised 82 TGA-negative children who were positive for human leucocyte antigen-DQ2 or -DQ8., Results: Based on receiver operating characteristic curves, the optimal cutoff value for immunoglobulin (Ig) A anti-DGP positivity was 153 arbitrary units (AUs) with a sensitivity of 92.4% and specificity of 97.6% and that for IgG anti-DGP 119 AU, with a sensitivity of 97.8% and specificity of 97.6%. All 92 children with CD were either IgA or IgG anti-DGP positive at the time of diagnosis. Sera from 48 children with CD were also analyzed retrospectively before the diagnosis. Anti-DGP antibodies preceded TGA positivity in 35 of the 48 children with CD and appeared a median of 1 year earlier., Conclusions: The TR-IFMA assay for detecting anti-DGP antibodies shows high sensitivity and specificity for the diagnosis of CD in children. In a majority of our study population, anti-DGP seropositivity preceded TGA positivity, indicating that earlier detection of CD may be possible by monitoring anti-DGP antibodies frequently in genetically susceptible children.
- Published
- 2015
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