Anti-tissue transglutaminase antibodies in coeliac disease are not a response to gut damage alone.
BACKGROUND
Anti-tissue transglutaminase (tTG) antibody is being used increasingly as a diagnostic tool in the serological investigation of coeliac disease. However, positive predictive values of immunoglobulin A anti-tTG for coeliac disease in prospective studies have been disappointing.


OBJECTIVE
To determine whether anti-tTG can arise as a non-specific consequence of abnormal gut permeability.


METHODS
A cohort from routine investigation for possible gluten-sensitive enteropathy, with 44 cases selected based on whether permeability studies had been performed.


METHODS
The cohort was assessed for anti-tTG by enzyme-linked immunosorbent assay, small-bowel biopsy and C-mannitol absorbency.


RESULTS
Eighteen of the 44 patients had biopsy-proven coeliac disease and 23 showed abnormal permeability. There was poor correlation between the level of anti-tTG and gut permeability.


CONCLUSIONS
These data confirm an association between anti-tTG and coeliac disease but no clear relationship with other forms of increased gut permeability.
Unsworth
David J
DJ
Immunology and Immunogenetics, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. joeunsworth@hotmail.com
Pitcher
Maxton C L
MC
Stevens
Susan
S
Lock
Robert J
RJ
D000328:Adult; D000906:Antibodies / Q000097:blood*; D002446:Celiac Disease / Q000276:immunology* / Q000378:metabolism; D004492:Edetic Acid / Q000378:metabolism; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007408:Intestinal Absorption; D008353:Mannitol / Q000378:metabolism; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology*
D000906:Antibodies; D007070:Immunoglobulin A; D008353:Mannitol; D004492:Edetic Acid; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins