title: Diagnostic value of duodenal antitissue transglutaminase antibodies in gluten-sensitive enteropathy.
abstract: BACKGROUND
  In gluten-sensitive enteropathy, antitissue transglutaminase antibodies are synthesized in the duodenum.
  
  
  OBJECTIVE
  To compare the diagnostic yield of these autoantibodies in cultured duodenal biopsies, duodenal aspirate and serum.
  
  
  METHODS
  Patients (n = 315, 135 female, 180 male; age: 37.3 +/- 1.1 years) referred for duodenal biopsies, were recruited and HLA-DQ2/DQ8 haplotyped. Histological measurements were made from duodenal biopsies and cultured duodenal biopsies were used for antitissue transglutaminase antibodies analysis by enzyme-linked immunosorbent assay. Duodenal aspirate was collected in a subgroup of 81 patients. Patients were classified, according to their histology, response to a gluten-free diet and DQ2/DQ8 status, as definite, likely or nongluten-sensitive enteropathy.
  
  
  RESULTS
  Histology was normal in 59% of patients; 28% had lymphocytic enteritis, 1% had crypt hyperplasia and 13% showed atrophy. In Marsh III patients, there was complete agreement between duodenal and serological antitissue transglutaminase antibodies measurements. Marsh I patients showed a slight antitissue transglutaminase antibodies sensitivity improvement in cultured duodenal biopsy compared to serum in definite (22% vs. 19%) and likely gluten-sensitive enteropathy (20% vs. 14%) patients. Combined serum and cultured duodenal biopsy antitissue transglutaminase antibodies assessment increased serological sensitivity from 19% to 30% in Marsh I patients.
  
  
  CONCLUSIONS
  Duodenal antitissue transglutaminase antibodies detection improves serological determination sensitivity in Marsh I patients, providing diagnostic value and therapeutic impact.
authors.affiliation: Department of Gastroenterology, Hospital Mútua de Terrassa, Fundació per la Recerca Mútua de Terrassa, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Santaolalla
authors.forename: F
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: R
authors.initials: R
authors.lastname: Rodríguez
authors.forename: M
authors.initials: M
authors.lastname: Alsina
authors.forename: M
authors.initials: M
authors.lastname: Rosinach
authors.forename: M
authors.initials: M
authors.lastname: Mariné
authors.forename: C
authors.initials: C
authors.lastname: Farré
authors.forename: A
authors.initials: A
authors.lastname: Salas
authors.forename: M
authors.initials: M
authors.lastname: Forné
authors.forename: C
authors.initials: C
authors.lastname: Loras
authors.forename: J
authors.initials: J
authors.lastname: Espinós
authors.forename: J M
authors.initials: JM
authors.lastname: Viver
authors.forename: M
authors.initials: M
authors.lastname: Esteve
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000175:diagnosis* / Q000276:immunology; D004386:Duodenum / Q000201:enzymology; D005260:Female; D006683:HLA-DQ Antigens / Q000276:immunology*; D006801:Humans; D008297:Male; D011503:Transglutaminases / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D011503:Transglutaminases