Antibodies against deamidated gliadin peptides in early-stage celiac disease.
OBJECTIVE
The widely used serum endomysial (EmA) and transglutaminase 2 (TG2-ab) antibodies predict forthcoming villous damage and celiac disease when the small-bowel mucosa structure is still normal. However, these autoantibodies may remain negative in this early stage of the disease. We hypothesized that the antibodies against deamidated gliadin peptides (DGP-AGA) might appear before the other antibodies and would thus be useful in the diagnosis and follow-up of patients with early-stage celiac disease.


METHODS
Serum DGP-AGA, TG2-ab, and EmA were measured at baseline and after 1 year on a gluten-free diet in 42 adults proven to have early-stage celiac disease despite normal small-bowel mucosal morphology (Marsh I-II), and in 20 celiac subjects evincing villous atrophy (Marsh III). Thirty-nine subjects with no signs of celiac disease served as nonceliac controls.


RESULTS
Sensitivity to detect early-stage celiac disease was 79% for DGP-AGA, 64% for TG2-ab, and 81% for EmA. Specificities were 95%, 100%, and 100%, respectively. The corresponding efficiencies of the tests were 89% for DGP-AGA, 81% for TG2-ab, and 91% for EmA. All 3 antibodies were significantly decreased on a gluten-free diet.


CONCLUSIONS
This study showed that the sensitivity of DGP-AGA was superior to TG2-ab and comparable to EmA in celiac patients having early-stage celiac disease with normal villous morphology. On the basis of these results, DGP-AGA would seem to offer a promising new method for case-finding and follow-up in this entity.
Pediatric Research Centre, University of Tampere, Helsinki, Finland.
Kalle
K
Kurppa
Katri
K
Lindfors
Pekka
P
Collin
Päivi
P
Saavalainen
Jukka
J
Partanen
Katri
K
Haimila
Heini
H
Huhtala
Kaija
K
Laurila
Markku
M
Mäki
Katri
K
Kaukinen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood*; D001284:Atrophy; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology* / Q000473:pathology; D055050:Diet, Gluten-Free; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005387:Finland; D019204:GTP-Binding Proteins; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology / Q000473:pathology; D007421:Intestine, Small / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000276:immunology*; D011237:Predictive Value of Tests; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012680:Sensitivity and Specificity; D013997:Time Factors; D011503:Transglutaminases / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
D000906:Antibodies; D001323:Autoantibodies; D015415:Biomarkers; D010446:Peptide Fragments; D005903:Gliadin; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins