A reliable screening test for coeliac disease: enzyme-linked immunosorbent assay to detect anti-gliadin antibodies in serum.
A simple, rapid, highly reproducible enzyme-linked immunosorbent assay detecting anti-gliadin antibodies in serum to screen for coeliac disease (CD) is described. By combining the results of anti-gliadin IgA and IgG determinations the overall sensitivity of the assay was found to be 100% and the specificity 96% for children and 99% for adults. Significantly elevated antigliadin IgA and IgG antibodies were detected in all 20 children and all 25 adults with untreated CD. False positive results were found in 1/79 histologically normal control and 5/86 disease control children, while for adults false positive rates were 0/74 and 1/34 for the healthy and disease control groups, respectively. Anti-gliadin IgA and IgG was measured in serum samples from 52 coeliac patients (11 children and 41 adults) treated with a gluten-free diet (GFD). Each of the children and 28 of the adults who followed a strict GFD had significantly lower IgA and IgG levels than untreated CD patients. The serum anti-gliadin IgA and IgG levels of the 13 adults not complying with a GFD were similar to those found for untreated CD patients. This assay is recommended as a screening test for CD as well as a tool for follow-up of treated patients.
Gonczi
J
J
School of Medicine, University of New South Wales, Kensington, Australia.
Skerritt
J H
JH
Mitchell
J D
JD
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000032:analysis*; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007223:Infant; D008297:Male; D010349:Patient Compliance; D012680:Sensitivity and Specificity
D000906:Antibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D005903:Gliadin