title: Detection of autoantibodies against tissue transglutaminase in patients with celiac disease and dermatitis herpetiformis.
abstract: OBJECTIVE
  Endomysial autoantibodies (EmA) are specific for celiac disease. The target antigen has been identified as tissue tranglutaminase (tTG). Our aim was to study the accuracy of a newly developed enzyme-linked immunosorbent assay (ELISA) for easy detection of tTG autoantibodies.
  
  
  METHODS
  Thirty-one sera from patients with histologically proven celiac disease and 23 healthy controls were examined for EmA using monkey esophagus and human umbilical cord as substrate. IgA-tTG autoantibodies were determined by newly developed ELISA. Additionally, sera from patients with dermatitis herpetiformis (n = 20), inflammatory bowel disease (IBD; n = 32), chronic liver disease (n = 36), and diabetes mellitus (n = 19) were tested.
  
  
  RESULTS
  The sensitivity of the tTG autoantibody ELISA accounted for 90% detection in patients with untreated celiac disease. The specificity was 76% owing to positive values in the lower range in patients with IBD (15%), chronic liver disease (36%), and diabetes (22%), all of whom were negative for EmA. In dermatitis herpetiformis patients 90% were EmA-positive. Of these, only 47% showed elevated tTG autoantibodies. Preincubation of sera from dermatitis patients with tTG abolished immunofluorescent staining of endomysial structures.
  
  
  CONCLUSIONS
  Detection of mid- to high-titer tTG autoantibodies is highly specific for celiac disease. However, in the low-titer range, overlap exists with liver disease, IBD, and diabetes. Tissue transglutaminase autoantibodies may evolve as a new screening and follow-up method for celiac disease. Although tTG seems to be a major autoantigen in dermatitis herpetiformis, the low sensitivity of both tTG ELISA and immunofluorescence using human umbilical cord suggests differential involvement of tTG in this disease.
authors.affiliation: Department of Internal Medicine, Charité, Humboldt-University, Berlin.
authors.forename: I
authors.initials: I
authors.lastname: Koop
authors.forename: R
authors.initials: R
authors.lastname: Ilchmann
authors.forename: L
authors.initials: L
authors.lastname: Izzi
authors.forename: A
authors.initials: A
authors.lastname: Adragna
authors.forename: H
authors.initials: H
authors.lastname: Koop
authors.forename: H
authors.initials: H
authors.lastname: Barthelmes
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000032:analysis*; D002446:Celiac Disease / Q000276:immunology*; D003874:Dermatitis Herpetiformis / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D004947:Esophagus / Q000276:immunology; D005455:Fluorescent Antibody Technique; D000882:Haplorhini / Q000276:immunology; D006801:Humans; D066298:In Vitro Techniques; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*; D014470:Umbilical Cord / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011503:Transglutaminases