Natural history of antibodies to deamidated gliadin peptides and transglutaminase in early childhood celiac disease.
BACKGROUND
Gliadin proteins play a key role in the pathogenesis of celiac disease; however, as a screen for celiac disease, anti-gliadin antibody testing has been replaced by the more sensitive and specific serological assays for transglutaminase autoantibodies (TGAA). A new generation of anti-gliadin antibody assays has been developed to detect synthetic, deamidated homologous gliadin peptides (DGP) with high sensitivity and specificity.


METHODS
Sera were collected prospectively from children with an increased risk for celiac disease as part of an ongoing study at Denver, and studied for the development of celiac autoimmunity. We investigated the high-performance DGP antibody assay in 50 TGAA-positive children both before the development of celiac autoimmunity and following the institution of a gluten-free diet to determine the relationship of DGP antibodies to TGAA. TGAA were measured by an in-house radioassay.


RESULTS
DGP antibodies and TGAA parallel each other over the period of years children were studied. DGP antibodies resolved sooner than TGAA in subjects on a gluten-free diet. DGP antibodies appeared earlier than TGAA in 9 children.


CONCLUSIONS
Measuring DGP antibodies may be more useful than TGAA in monitoring children on a gluten-free diet. DGP antibodies can precede the appearance of TGAA in some at-risk children.
Liu
Edwin
E
Section of Gastroenterology, Hepatology and Nutrition, The Children's Hospital, and Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver and Health Sciences Center, Denver, CO, USA. edwin.liu@uchsc.edu
Li
Marcella
M
Emery
Lisa
L
Taki
Iman
I
Barriga
Kathy
K
Tiberti
Claudio
C
Eisenbarth
George S
GS
Rewers
Marian J
MJ
Hoffenberg
Edward J
EJ
D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D005903:Gliadin / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010446:Peptide Fragments; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011503:Transglutaminases / Q000276:immunology*
D001323:Autoantibodies; D010446:Peptide Fragments; D005903:Gliadin; D011503:Transglutaminases