Insights in the laboratory diagnosis of celiac disease.
The present report focuses on the diagnosis of celiac disease and its pathogenesis, which depends on a genetic predisposition (HLA DQ2 or DQ8 haplotypes), gluten ingestion and T cell activation, type II transglutaminase (TG2), the autoantigen recognized by the antiendomysial antibody playing a key role. IgA class antibody anti-environmental (gliadin) and endogenous (TG2) antigens are present in the sera of patients with celiac disease. The anti-TG2 antibody has the best available diagnostic accuracy, especially when measured employing second generation ELISA tests, which use the human TG2 antigen, or immunochemiluminescent assay, which is highly sensitive. A diagnosis of celiac disease must always be confirmed by the histological evaluation of multiple duodenal mucosa specimens, and serology is recommended for follow-up controls.
Basso
D
D
Department of Laboratory Medicine, University of Padova, Italy.
Guariso
G
G
Fogar
P
P
Navaglia
F
F
Zambon
C-F
CF
Plebani
M
M
D000906:Antibodies / Q000032:analysis / Q000276:immunology; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology; D019411:Clinical Laboratory Techniques; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005903:Gliadin / Q000276:immunology; D006801:Humans; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology
D000906:Antibodies; D005903:Gliadin; D011503:Transglutaminases