Anti-human versus anti-guinea pig tissue transglutaminase antibodies as the first-level serological screening test for coeliac disease in the general population.
BACKGROUND
So far the reliability of the anti-guinea pig and anti-human tissue transglutaminase antibodies for the coeliac disease diagnosis has been evaluated in selected groups of patients.


OBJECTIVE
To compare the diagnostic accuracy of anti-human versus anti-guinea pig tissue transglutaminase in the coeliac disease screening of the general population.


METHODS
Two healthy Italian populations living in Marche region and in Western Sardinia.


METHODS
Both anti-guinea pig and anti-human tissue transglutaminase were determined using an enzyme-linked immunosorbent assay-based commercially available kit (Eu-tTG, Eurospital, Trieste, Italy).


RESULTS
During the period 1999-2001, 3541 subjects (1500 from "continental" Italy and 2041 from Sardinia) were screened for coeliac disease using both anti-guinea pig and anti-human tissue transglutaminase as first-level tests. Both these tests were negative in 3439/3541 sera, while 29 resulted positive for both of them and 73 showed discordant results. Overall, 50 intestinal biopsies were performed in 22, 21 and 7 subjects with positivity to both screening tests, to anti-guinea pig and to anti-human tissue transglutaminase alone, respectively. A coeliac disease diagnosis was made in 25 subjects giving an overall prevalence of 1:126 individuals. The anti-tissue transglutaminase specificity and sensitivity were 98 and 92% for guinea pig and 99.6 and 96% for human tissue transglutaminase, respectively.


CONCLUSIONS
The anti-human tissue transglutaminase test should definitely replace the anti-guinea pig-derived one as first-level screening tool for identifying all subjects who need the second-level investigations (small intestinal biopsy).
Fabiani
E
E
Department of Pediatrics, University of Ancona, Via F. Corridoni no. 11, 60123 Ancona, Italy.
Peruzzi
E
E
Mandolesi
A
A
Garbuglia
G
G
Fanciulli
G
G
D'Appello
A R
AR
Gasparin
M
M
Bravi
E
E
Bearzi
I
I
Galeazzi
R
R
Catassi
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000906:Antibodies / Q000097:blood*; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis*; D004797:Enzyme-Linked Immunosorbent Assay; D006168:Guinea Pigs; D006801:Humans; D007558:Italy; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*
D000906:Antibodies; D011503:Transglutaminases